Harumi Ramanayake^1,2*, Eoin Minnock¹ and David O’Brien¹

¹Beaumont Hospital, Beaumont Road, Beaumont, Dublin 9, Ireland
²Royal College of Surgeons in Ireland, St. Stephen’s Green, Dublin 2, Ireland

*Corresponding Author: Harumi Ramanayake, Beaumont Hospital, Beaumont Road, Beaumont, Dublin 9, Ireland.

Received: June 19, 2025; Published: July 31, 2025

Abstract

Over the last decade, prevention of thromboembolism from nonvalvular atrial fibrillation has become more reliant on newly developed oral anticoagulants such as apixaban, an example of a direct oral anticoagulant (DOAC) [1]. One of the major benefits of apixaban is that not only this drug is fast acting but it also avoids the requirement of regular therapeutic monitoring, as is required with warfarin [1]. Apixaban is also known to have decreased risk of bleeding in comparison to warfarin [1]. Apixaban is now being increasingly prescribed due to its superiority in the prevention of stroke or systemic embolism in comparison to historical anticoagulation therapy [1]. Here, we report a case of spontaneous spinal epidural haematoma with long-term apixaban use, which has not been described as a potential side effect in the product monograph [2] nor in any other previous case report identified in the literature. The aim of this report is to help clinicians appreciate the relevance of spinal haematoma in the context of DOAC use. This review includes studies sourced from several databases including Pubmed, Google Scholar and Medline for collating evidence-based studies. It prudent as clinicians to be aware of this potential complication and exercise caution particularly as frequency of prescribing apixaban continues to rise globally.

Keywords: Apixaban; Spinal Stroke; Spontaneous Spinal Epidural Haematoma; Neurosurgery

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Citation

Citation: Harumi Ramanayake., et al. “Spontaneous Spinal Epidural Haematoma on Apixaban: An Updated Review". Acta Scientific Clinical Case Reports 6.8 (2025): 30-35.

Copyright

Copyright: © 2025 Harumi Ramanayake., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.