[Spinal subdural hematoma following spinal anesthesia in a patient without coagulation abnormalities].
We experienced an extremely rare complication of spinal anesthesia, a spinal subdural hematoma, in a 56-year-old man. Delayed paraplegia became apparent after the discharge from hospital, and at approximately 30 hours after the dural puncture. Surgical decompression of nerve fibers and removal of the hematoma were performed at 37 hours after the puncture. Neurological symptoms stared to recover immediately after the surgery, and at 3 months after the surgery, the patient mostly recovered his muscle powers and sensory functions. In the preoperative assessments, the patient did not have coagulation abnormality; however, several punctures were necessary for the proper needle placement during the spinal anesthesia procedure. Awareness of this rare complication, and the importance of rapid diagnosis by CT or MRI imaging followed by immediate surgical decompression should be emphasized to prevent permanent neurological deficits. Also, patients undergoing spinal anesthesia should be told to report back to hospital if they experience any neurological abnormalities.
Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi 371-8511.
Masaru
M
Tobe
Yasunori
Y
Sorimachi
Akihiro
A
Tomioka
Shigeru
S
Saito
D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001777:Blood Coagulation; D019299:Decompression, Surgical; D046649:Hematoma, Subdural, Spinal / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome