An epidural hematoma in an adolescent patient after cardiac surgery.
An 18-yr-old patient had a thoracic epidural placed under general anesthesia preceding an uneventful aortic valve replacement with a bioprosthetic valve. On the second postoperative day, he was anticoagulated and also received an antithrombotic medication. While ambulating, he experienced pain in his back, and there was blood in his epidural catheter. The catheter was removed, and he developed motor and sensory loss. Rapid surgical decompression resulted in recovery of his lost neurological function. Management and strategies for preventing this problem are discussed.


CONCLUSIONS
Epidural hematoma is a rare complication of epidural anesthesia and has not been reported in pediatric patients undergoing cardiac surgery. The successful treatment of this complication requires swift recognition, diagnosis, and surgical intervention.
Rosen
David A
DA
Departments of *Anesthesiology, †Pediatrics, ‡Surgery, and §Radiology, West Virginia University Children's Hospital, West Virginia University School of Medicine, Morgantown.
Hawkinberry
Denzil W
DW
Rosen
Kathleen R
KR
Gustafson
Robert A
RA
Hogg
Jeffery P
JP
Broadman
Lynn M
LM
D000293:Adolescent; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000295:instrumentation; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D001705:Bioprosthesis; D006348:Cardiac Surgical Procedures; D006400:Hematocrit; D006407:Hematoma, Epidural, Cranial / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010149:Postoperative Pain / Q000628:therapy; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011183:Postoperative Complications / Q000209:etiology*; D019919:Prosthesis Implantation