Major neurological sequelae of lumbar epidural anesthesia. Report of three cases.
We here report the major permanent neurological complications that developed in three patients after epidural anesthesia. MR clearly showed that paraplegia, which arose one and nine days after anesthesia, was due to epi-subdural haematoma in the first case and epidural abscess in the second. The sudden left lower limb palsy in the third patient was caused by a paracentral ischemic lesion all along the conus-epiconus following a probable trauma of the cord during the insertion of the needle. Despite the fact that this was reported to have been performed at L1-L2, an erroneous introduction into the upper interspace must be postulated since the spinal cord of this patient terminated at mid-L1. Our report is useful insofar as it may remind anesthesiologists and neurologists to pay attention to the unusual complications of spinal anesthesia that may require urgent intervention.
Barontini
F
F
Clinica Neurologica III, Università di Firenze, Italy.
Conti
P
P
Marello
G
G
Maurri
S
S
D000038:Abscess / Q000209:etiology; D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D002420:Cauda Equina / Q000473:pathology; D004824:Epidural Space; D007172:Erectile Dysfunction / Q000209:etiology; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology*; D010264:Paraplegia / Q000209:etiology; D013116:Spinal Cord / Q000098:blood supply; D013119:Spinal Cord Injuries / Q000209:etiology*; D013355:Subdural Space; D016055:Urinary Retention / Q000209:etiology