International Journal of
Medicine and Medical Sciences

  • Abbreviation: Int. J. Med. Med. Sci.
  • Language: English
  • ISSN: 2006-9723
  • DOI: 10.5897/IJMMS
  • Start Year: 2009
  • Published Articles: 523

Case Report

Spinal subdural hematoma associated with phenytoin use

Abrar Ahad Wani
  • Abrar Ahad Wani
  • Department of Neurosurgery, Sher-i- Kashmir Institute of Medical Sciences, Srinagar, J&K. India.
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Anil Dhar
  • Anil Dhar
  • Department of Neurosurgery, Sher-i- Kashmir Institute of Medical Sciences, Srinagar, J&K. India.
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Nayil Kkursheed Malik
  • Nayil Kkursheed Malik
  • Department of Neurosurgery, Sher-i- Kashmir Institute of Medical Sciences, Srinagar, J&K. India.
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Altaf Umar Ramzan
  • Altaf Umar Ramzan
  • Department of Neurosurgery, Sher-i- Kashmir Institute of Medical Sciences, Srinagar, J&K. India.
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  •  Accepted: 28 April 2011
  •  Published: 30 May 2011

Abstract

 

A rare case of spinal subdural hematoma (SSDH) is reported in a patient who was receiving phentoin. The hematoma occurred because of combined effects of trauma and underlying haematological disturbance induced by phenytoin. A young male who was a known case of seizure disorder and was receiving phenytoin for last 10 years presented with history of seizure followed by fall from one storey of his house. This was followed by paraplegia. MRI revealed presence of spinal subdural hematoma in dorsolumbar spine. His haematological parameters revealed deranged coagulogram and anemia with thrombocytopenia. The patient underwent laminectomy and evacuation of hematoma and intrathecal drain was kept in for three days till drainage was clear. However the patient did not improve clinically. His anemia and thrombocytopenia responded rapidly to administration of vitamin B12 and stoppage of phenytoin. SSDH should be kept a possibility in posttraumatic paraplegia. The patients receiving phenytoin must be monitored for change in hematological parameters after chronic use.

 

Key words: Spinal, subdural, hematoma.