title: Case report: epidural hematoma nine days after removal of a labor epidural catheter.
abstract: Timely recognition and surgical decompression are crucial to minimize risk of permanent neurologic deficit from epidural hematoma. We present the case of a patient who developed acute back pain, sensory deficit, and ascending weakness 9 days after removal of a labor epidural catheter. Magnetic resonance imaging revealed a heterogeneous fluid collection extending from C6-7 through the lumbar region, with cord deformity at T9-11. Decompression laminectomy was performed within 4 hours of symptom onset. Twelve hours later, her motor function had fully recovered. Subsequent anatomic and hematologic workup was inconclusive. This presentation is atypical given the delayed presentation of symptoms after epidural placement.
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA 94143-0648, USA. eshimar@anesthesia.ucsf.edu
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Guffey
authors.forename: Warren R
authors.initials: WR
authors.lastname: McKay
authors.forename: Rachel Eshima
authors.initials: RE
authors.lastname: McKay
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000295:instrumentation; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D006801:Humans; D011247:Pregnancy; D013997:Time Factors