Spinal cord infarction after decompressive laminectomy for spontaneous spinal epidural hematoma--case report.
A 68-year-old woman presented to the emergency department for evaluation of bilateral leg weakness. On admission, she had paraparesis with incomplete sensory deficit. Magnetic resonance (MR) imaging of the thoracolumbar spine revealed spontaneous spinal epidural hematoma (SSEH) compressing the spinal cord. The patient was taken to the operating room for urgent surgical decompression and evacuation of the SSEH. After the surgery, she woke up with complete paraplegia. Postoperative MR imaging showed the spinal cord was edematous, with minimal remnant hematoma. MR imaging after 1 month clearly showed anterior spinal artery thrombosis. No significant neurological improvement occurred during the 3-month follow up. Surgeons should consider the possibility of this devastating complication before aggressive and early surgical intervention in a patient with SSEH causing cord compression and neurological deficit.
Park
Juno
J
Department of Neurosurgery, Korea University Ansan Hospital, Korea University School of Medicine, Seoul, R.O.K.
Lee
Jang Bo
JB
Park
Jung Yul
JY
Lim
Dong Jun
DJ
Kim
Sang Dae
SD
Chung
Yong Ku
YK
D019299:Decompression, Surgical / Q000009:adverse effects; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000150:complications* / Q000601:surgery; D006801:Humans; D007238:Infarction / Q000209:etiology* / Q000628:therapy; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D010264:Paraplegia / Q000209:etiology*; D013116:Spinal Cord / Q000098:blood supply* / Q000473:pathology; D013904:Thoracic Vertebrae; D016896:Treatment Outcome