[Cerebrovascular accident: differential diagnosis of a compressive spinal hematoma].
We report the case of a 84-year-old patient who developed a monoplegia of the left inferior limb after a spinal anaesthesia for femoral neck's fracture. The magnetic resonance imaging (MRI) carried out in emergency, eliminated a spinal compression. The final diagnosis was a cerebral stroke. This observation leads us to discuss the choice of anaesthesia technical, the various aetiologies of a neurological trouble after spinal anaesthesia. The appearance of clinical signs evoking a spinal haematoma, must make seek by the imagery (MRI or scanner) the signs of spinal compression in order to propose an emergency laminectomy. Finally we insist on the importance but also on the difficulties of the clinical examination in elderly traumatic patients.
Morel
J
J
Département d'anesthésie-réanimation, CHU, 42055 Saint-Etienne, France.
Michard
C
C
Benvenuto
V
V
Braly
G
G
D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005264:Femoral Fractures / Q000601:surgery*; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000209:etiology; D020521:Stroke / Q000150:complications* / Q000175:diagnosis*