• Reg Anesth Pain Med · Jan 2014

    Case Reports

    An Epidural Blood Patch Causing Acute Neurologic Dysfunction Necessitating a Decompressive Laminectomy.

    • Sonya P Mehta, Bart P Keogh, and Arthur M Lam.
    • From the *Neuroanesthesia and Neurocritical Care, Swedish Medical Center, Seattle; †Physician Anesthesia Service, Seattle; ‡Radiology, Swedish Neuroscience Institute, Swedish Medical Center, Seattle; and §Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA.
    • Reg Anesth Pain Med. 2014 Jan 1;39(1):78-80.

    ObjectivesOne risk with placement of an epidural blood patch (EDBP) is spinal cord or nerve root compression resulting from the epidural blood volume injected, a complication necessitating immediate surgical decompression. We could not find a previous report of this in the literature. Here, we review and discuss one such case.Case ReportA patient was treated with 2 EDBPs for a presumptive cerebrospinal fluid leak 3 weeks after an epidural steroid injection. The second EDBP was performed under direct fluoroscopic guidance, yet resulted in spinal cord compression with radiologic evidence of an epidural hematoma. The patient developed acute cauda equina syndrome and required an emergent decompressive laminectomy resulting in partial resolution of neurological symptoms. One year after the procedure, the patient has recovered most of her motor function but with some persistent numbness below the left knee and a left foot drop.ConclusionsA cauda equina syndrome from an epidural hematoma may occur as a rare complication of an EDBP, even with direct fluoroscopic guidance. Early diagnosis of symptoms and prompt surgical evacuation of an epidural hematoma is essential and may result in the resolution of symptoms. This complication remains a rare occurrence and should not deter the performance of an EDBP, when indicated.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…