Spinal subdural haematoma in von Willebrand disease

Abstract

Background. Von Wilebrand disease (vWD) is the most common inherited disorder of hemostasis. Bleeding in patients with von Wilebrand disease is a frequently reported complaint. Patients with inherited bleeding disorders are also in a large number of cases infected with hepatitis C virus (HCV). Studies showed an increased risk factor for intracerebral hemorrhage (ICH) in patients infected with HCV receiving the combination treatment.Case report. A 44-year old man reported to our Emergency Department with low back pain, headaches, neck pain, leg weakness and urinary retention. The neurological examination showed nuchal rigidity and spastic paraparesis. Thoracic spine MRI revealed a subacute subdural haematoma at T8-T11 level.Conclusions. To the best of our knowledge, this is the first report of a subdural haematoma of the thoracic spine in a patient with vWD and chronic HCV infection. The presented patient was receiving a combination treatment, a fact that has also to be taken in consideration as a possible risk factor for a bleeding episode.