title: [Transient paraplegia due to epidural hematoma after catheter withdrawal].
abstract: A 58-year-old man with hypertension underwent laparoscopic distal gastrectomy under general and epidural anesthesia. Preoperative laboratory date revealed a normal platelet count and normal coagulation profile. Epidural puncture was successfully performed at the T9-10 intervertebral space on the first attempt without bleeding. An epidural catheter was smoothly inserted 5 cm cephalad. On the third postoperative day, paraplegia due to thoracic epidural hematoma developed shortly after extraction of the catheter. At that time, his blood pressure was 190/102 mmHg because of a pain due to walk. On using a hypotensive drug, his blood pressure fell. Ten minutes later, paraplegia disappeared spontaneously. It is suggested that the spinal cord of the patient was subjected to transient pressure hematoma. A decline in blood pressure may have caused the blood to spread through the epidural space, such that the neurologic symptoms disappeared.
authors.affiliation: Division of Anesthesiology, Tokushima Red Cross Hospital, Tokushima 773-8502.
authors.forename: Kaori
authors.initials: K
authors.lastname: Nakai
authors.forename: Kaori
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Tobetto
authors.forename: Naoji
authors.initials: N
authors.lastname: Mita
authors.forename: Narutomo
authors.initials: N
authors.lastname: Wakamatsu
authors.forename: Michihisa
authors.initials: M
authors.lastname: Kato
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Go
authors.forename: Arifumi
authors.initials: A
authors.lastname: Kohyama
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects*; D002404:Catheterization / Q000009:adverse effects; D046748:Hematoma, Epidural, Spinal / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology*