[Spontaneous resolution of a paraparesis due to a dorsolumbar epidural haematoma associated with subarachnoid anaesthesia and postoperative analgesia using an epidural catheter].
Spinal epidural haematoma after neuroaxial anaesthesia is a rare but serious complication. Most cases are attributed to anticoagulant therapy or bleeding tendency. It presents as an acute spinal cord compression and usually requires emergency surgical decompression. The interval between the onset of clinical signs and surgical evacuation is very important, influencing the neurological prognosis. We report a case of a spinal epidural haematoma after epidural analgesia in a patient who was treated with low molecular weight heparin for thrombo-prophylaxis in the perioperative period. In some cases, such as the one reported here, good neurological recovery can be achieved with conservative management.
Servicio de Anestesiología y Reanimación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España. mariacarmen.sanchezg@sjd.es
C
C
Sánchez Gutiérrez
A
A
Alemán Martín
V
V
Coronado Hijón
P
P
Jiménez Delgado
D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects*; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000925:Anticoagulants / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee; D003951:Diagnostic Errors; D017984:Enoxaparin / Q000009:adverse effects; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000139:chemically induced / Q000209:etiology*; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D010149:Postoperative Pain / Q000188:drug therapy; D020335:Paraparesis / Q000209:etiology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D012075:Remission, Spontaneous; D013117:Spinal Cord Compression / Q000209:etiology*; D013345:Subarachnoid Hemorrhage / Q000139:chemically induced / Q000209:etiology*; D013904:Thoracic Vertebrae; D013924:Thrombophlebitis / Q000175:diagnosis
D000925:Anticoagulants; D017984:Enoxaparin