Spinal Cord Hemorrhage Treatment & Management

Updated: Mar 11, 2014
  • Author: Richard M Zweifler, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Treatment

Medical Care

Medical therapies for spinal cord hemorrhage are limited.

  • If the bleed is caused by a coagulopathy, reversal of the bleeding tendency is crucial. Examples include fresh frozen plasma and vitamin K or Prothrombin Complex Concentrate for warfarin-induced bleeds, protamine sulfate for heparin-induced bleeds, platelet transfusions for thrombocytopenia, specific clotting factor concentrates or fresh frozen plasma for clotting factor deficiencies such as hemophilia and Christmas disease. The optimal treatment to reverse the effects of the new oral anticoagulants is unknown.
  • Another potential medical treatment, drug therapy for cord edema, is unproved.
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Surgical Care

See the list below:

  • Depending on etiology, surgery may be indicated for hematomyelia.
  • In general, surgery should be performed in spinal subdural hemorrhage and epidural hemorrhage.
  • Treatment of spinal subarachnoid hemorrhage consists of bed rest and surgical resection of extramedullary angiomas, when present.
  • Spinal angiomas also can be approached by catheter-based interventional techniques, such as embolization or coiling.
  • Focal radiation therapy (eg, gamma knife or cold photon knife) is also a consideration with spinal arteriovenous malformations.
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Consultations

See the list below:

  • Neurologist
  • Neurosurgeon
  • Interventional neuroradiologist
  • Radiation oncologist
  • Hematologist
  • Rehabilitation physician (physical medicine and rehabilitation, neurology)
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