title: Acute intrathecal haematoma following neuraxial anaesthesia: diagnostic delay after apparently normal radiological imaging.
abstract: We describe a case of intrathecal haematoma following combined spinal-epidural anaesthesia for caesarean section. The parturient was previously well with no risk factors for haematoma development. Surgical intervention was delayed, resulting in permanent neurological injury. Incorrect interpretation of clinical findings and magnetic resonance imaging contributed to the delay in definitive treatment. We discuss the difficulties in diagnosis, image interpretation and the need for a specialist opinion when abnormal neurological symptoms persist despite apparently normal imaging.
authors.affiliation: Department of Anaesthesia, University Hospital Gasthuisberg, Leuven, Belgium. mawalters@doctors.net.uk
authors.forename: M A
authors.initials: MA
authors.lastname: Walters
authors.forename: M
authors.initials: M
authors.lastname: Van de Velde
authors.forename: G
authors.initials: G
authors.lastname: Wilms
mesh_terms: D000208:Acute Disease; D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D017604:Cesarean Section, Repeat; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007278:Injections, Spinal; D007796:Laminectomy; D008279:Magnetic Resonance Imaging / Q000379:methods; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology; D011247:Pregnancy; D014057:Tomography, X-Ray Computed