title: [Iatrogenic cervical epidural hematoma: case report and review of the literature].
abstract: BACKGROUND
  Around 600 spinal epidural hematoma cases have been previously reported. Incidence of paraplegia after epidural anesthesia varies between 0,0005 and 0,02%. Several possible etiologies have been described in the literature, including surgery, trauma, anticoagulant therapy, arteriovenous malformations, pregnancy and lumbar puncture. Spinal and epidural anesthesic procedures represent the tenth most common cause. But in combination with anticoagulant therapy, the forementioned procedures increase its incidence until reaching the fifth most common etiological group. We report the case of an 80 year-old-man with a cervical epidural hematoma who had a good outcome with conservative management.
  
  
  METHODS
  80 year-old-man that developed intense cervicalgia with lower limbs weakness showing complete paraplegia and arreflexia 2 hours after analgesic treatment with epidural cervical infiltration for cervicoartrosis. Cervical MRI showed epidural cervical hematoma between C4 and T1 levels. The patient is transferred to our facilities in order to perform surgery. But after showing fast recovery, medical conservative management was elected. After one month, the patient's condition has improved showing no neurological deficits and complete resorption is seen in MRI.
  
  
  CONCLUSIONS
  Nowadays, trend is to perform surgery in patients with spinal hematoma and significant neurological deterioration during the first hours. However, good neurological outcomes can be achieved with conservative management, in well selected patients with non progressive, incomplete and partial deficits. Presently, we can not predict which is the best treatment for each case.
authors.affiliation: Servicio de Neurocirugía. Hospital Universitario de Getafe. Madrid. ijusue.hugf@salud.madrid.org
authors.forename: I
authors.initials: I
authors.lastname: Jusué-Torres
authors.forename: J M
authors.initials: JM
authors.lastname: Ortega-Zufiria
authors.forename: M
authors.initials: M
authors.lastname: Tamarit-Degenhardt
authors.forename: R
authors.initials: R
authors.lastname: Navarro Torres
authors.forename: R
authors.initials: R
authors.lastname: López-Serrano
authors.forename: J
authors.initials: J
authors.lastname: Riqué-Dormido
authors.forename: P
authors.initials: P
authors.lastname: Aragonés-Cabrerizo
authors.forename: J C
authors.initials: JC
authors.lastname: Gómez-Angulo
authors.forename: P
authors.initials: P
authors.lastname: Poveda-Nuñez
authors.forename: P
authors.initials: P
authors.lastname: Jerez-Fernández
authors.forename: J M
authors.initials: JM
authors.lastname: Del Pozo-García
mesh_terms: D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D002574:Cervical Vertebrae; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007049:Iatrogenic Disease; D007267:Injections / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D011247:Pregnancy; D055009:Spondylosis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000700:Analgesics