Hematoma epidural cervical yatrogénico. Presentación de un caso clínico y revisión de la literatura

Jusué-Torres, I.; Ortega-Zuiria, J. M.; Tamarit-Degenhardt, M.; Torres, R. Navarro; López-Serrano, R.; Riqué-Dormido, J.; Aragonés-Cabrerizo, P.; Gómez-Angulo, J. C.; Poveda-Nuñez, P.; Jerez-Fernández, P.; Del Pozo-García, J. M.
August 2011
Revista Neurocirugia;ago2011, Vol. 22 Issue 4, p332
Academic Journal
Background. Around 600 spinal epidural hematoma cases have been previously reported. Incidence of paraplegia after epidural anesthesia varies between 0,0005 and 0,02%. Several possible etiologies have been described in the literature, including surgery, trauma, anticoagulant therapy, arteriovenous malformations, pregnancy and lumbar puncture. Spinal and epidural anesthesic procedures represent the tenth most common cause. But in combination with anticoagulant therapy, the forementioned procedures increase its incidence until reaching the fifth most common etiological group. We report the case of an 80 year-old-man with a cervical epidural hematoma who had a good outcome with conservative management. Case report. 80 year-old-man that developed intense cervicalgia with lower limbs weakness showing complete paraplegia and arreflexia 2 hours after analgesic treatment with epidural cervical infiltration for cervicoartrosis. Cervical MRI showed epidural cervical hematoma between C4 and T1 levels. The patient is transferred to our facilities in order to perform surgery. But after showing fast recovery, medical conservative management was elected. After one month, the patient's condition has improved showing no neurological deficits and complete resorption is seen in MRI. Conclusions. Nowadays, trend is to perform surgery in patients with spinal hematoma and significant neurological deterioration during the first hours. However, good neurological outcomes can be achieved with conservative management, in well selected patients with non progressive, incomplete and partial deficits. Presently, we can not predict which is the best treatment for each case.


Related Articles

  • Epidural haematoma: Rare complication after spinal while intending epidural anaesthesia with long-term follow-up after conservative treatment. Goswami, Devalina; Das, Jyotirmoy; Deuri, Achyut; Deka, \Ajit K. // Indian Journal of Anaesthesia;Jan/Feb2011, Vol. 55 Issue 1, p71 

    Epidural anaesthesia (EA) is an extensively used procedure for many surgeries. Increase incidence of bleeding in the epidural space [epidural haematoma (EH)] is reportedly more common in patients with altered coagulation and patients on anticoagulation treatment. EH secondary to spinal while...

  • Spontaneous Spinal Epidural Haematoma: A Case Report. Rispoli, R.; Mastrostefano, R. // Neuroradiology Journal;Feb2010, Vol. 23 Issue 1, p85 

    Spinal epidural haematomas are infrequent events caused mainly by trauma or are iatrogenic following invasive spinal procedures (lumbar puncture, surgery or peridural anaesthesia). Spontaneous spinal epidural haematoma is a rare entity requiring emergency intervention in most cases. The...

  • Injeção epidural preventiva de xilazina ou amitraz, em eqüinos: efeito autinociceptivo. do Prado Guirro, Erica Cristina Bueno; Sobrinho, Guilherme Roberto; Ferreira, Isabella Maria Marchesini; Valadão, Carlos Augusto Araújo // Ciência Rural;ene2009, Vol. 39 Issue 1, p104 

    Epidural administration of a2 agonists promotes antinociceptive effect and amitraz acts on a2 receptors. Antinociceptivo effect caused by pre-emptive epidural injection of 0.17mg kg-1 xylazine (GX) or 0.1mg kg-1 amitraz diluted in lipidic emulsion (GA) were evaluated, in 12 horses submitted by...

  • Blood on the Spine: Neuraxial Anesthetic Considerations. Crist, Erin L. // International Student Journal of Nurse Anesthesia;Fall2012, Vol. 11 Issue 3, p4 

    The article presents a case study of a 59 year old Caucasian male presented for a left below the knee amputation due to non-healing osteomyelitis. Neuraxial anesthesia is the administration of a local anesthetic or analgesic drug injected in either the subarachnoid or epidural space. The article...

  • Iatrogenic subdural hematoma mimicking acute epidural hematoma on computed tomography. Ak, Hakan; Yolcu, Sadiye; Atalay, Tugay; Kış, Naciye // Journal of Clinical & Experimental Investigations / Klinik ve De;Sep2013, Vol. 4 Issue 3, p367 

    Computed tomography images of the subdural and epidural hematoma are well defined, crescent and lentiform shapes, respectively. However, it has been reported that both of them might mimic each other in rare instances. Literature reveals seven reports subdural hematoma mimicking epidural. We are...

  • Hematoma in the cervical ligamentum flavum. Report of a case and review of the literature. Tatsuya Tamura; Toshinori Sakai; Koichi Sairyo; Shoichiro Takao; Seiko Kagawa; Shinsuke Katoh; Natsuo Yasui // Skeletal Radiology;Mar2010, Vol. 39 Issue 3, p289 

    Abstract  Hematoma of the cervical ligamentum flavum is very rare, and its pathogenesis is unknown. We describe a case of ligamentum flavum hematoma in the cervical spine causing severe myelopathy. Postoperative histological examination suggested it was the result of the rupture of a...

  • Central neuraxial blockade in ambulatory surgery. Arakawa, Masayuki // Journal of Anesthesia;2003, Vol. 17 Issue 2, p149 

    Comments on an article about the clinical assessment of spinal and epidural anesthesia in inguinal hernia repair. Physiological impact of epidural bupivacaine anesthetic; Efficacy of spinal anesthesia in relaxing muscles; Types of epidural anesthesia.

  • `Walking epidural' blocks labor pain.  // USA Today Magazine;Oct97, Vol. 126 Issue 2629, p8 

    Reports that the technique called combined spinal-epidural (CSE) analgesia eliminates early labor discomfort in less time than conventional labor drugs and without impairing a woman's ability to walk. How it works; The two choices that pregnant women had for pain relief before the development...

  • Recent advances in obstetric anesthesia. Farragher, Rachel; Datta, Sanjay // Journal of Anesthesia;2003, Vol. 17 Issue 1, p30 

    Reviews the current opinion on several areas of obstetric anesthesia as of February 2003. Discussion on combined spinal/epidural technique; Role of spinal anesthesia for cesarean section in severe preeclampsia; Acute hydration prior to spinal anesthesia; Blood conservation strategies in obstetrics.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics