Epidural Hematoma Following Computed Tomography (CT) Myelography With Continued Antithrombotic Therapy: Two Cases Demonstrating Full Neurological Recovery

TL;DR

Two elderly patients developed epidural hematomas after CT myelography while on antithrombotic therapy but fully recovered after emergency surgery.

Contribution

The study demonstrates that full neurological recovery is possible with prompt surgical intervention despite ongoing anticoagulation.

Findings

Epidural hematomas occurred in two patients after CT myelography while on antithrombotic therapy.

Emergent decompression within six hours led to complete neurological recovery in both cases.

Continuation of anticoagulation may be feasible with close monitoring in select patients.

Abstract

Epidural hematoma after computed tomography (CT) myelography is a rare but potentially devastating complication. We report two elderly patients who developed epidural hematomas shortly after undergoing CT myelography, despite continuation of antiplatelet or anticoagulant therapy. In both cases, emergent decompression surgery was performed within six hours of symptom onset, resulting in complete neurological recovery. These cases underscore the importance of prompt recognition and intervention and suggest that continuation of anticoagulation may be feasible under close monitoring in select patients.

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