PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “HEMATOMA, EPIDURAL”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1981

Orbital subperiosteal hematoma (epidural hematoma of the orbit).

Three cases are presented of subperiosteal hematomas, which can be thought of as epidural hematomas of the orbit. One occurred in a child associated with an episode of violent vomiting, the second in an adult with a history of remote head trauma who presented with a slowly progressive course suggestive of thyroid eye disease, and the third in a young patient after acute trauma probably associated with the injections of a local anesthetic agent or possibly the passage of a deep suture. Skull x-rays, computed tomography, and ultrasonographic examinations detected and localized the lesion in each case. Both patients who were operated on enjoyed prompt and total resolution of their symptoms after surgical extirpation of the lesion. In the third patient, the lesion regressed on its own.

Adult↗
PubMed1980

Chronic epidural hematomas.

Epidural hematomas generally become manifested within hours after trauma because of progressive obtundation and later transtentorial herniation. However, epidural hematomas located outside the temporal fossa may produce vague neurological symptoms of delayed onset. Emergency operation may not adequately expose those blood clots located in unexpected positions. Computed tomographic (CT) brain scans will reveal the full extent and location of these hematomas. Seven cases of chronic epidural hematoma in various extratemporal locations are reported to emphasize their misleading clinical courses, their demonstration by CT scanning, and the underlying pathophysiology.

Adolescent↗
PubMed2002

Epidural hematoma after epidural block: implications for its use in pain management.

BACKGROUND: Spinal epidural hematoma after spinal puncture such as for injection of steroids for pain management may result in a rare complication of a spinal epidural hematoma causing acute myelopathy. Although this complication is well known with epidural anesthesia, where it is usually seen with impaired hemostasis, there are surprisingly few case reports of epidural hematoma after an epidural steroid block. CASE DESCRIPTION: A healthy 34-year-old man with no evidence of coagulopathy and not taking antiplatelet medication suddenly had onset of acute cervical myelopathy from a large cervical epidural hematoma 8 days after a cervical epidural steroid block. Following prompt surgical evacuation of the clot, the patient made a near complete recovery. CONCLUSION: Spinal epidural hematoma after spinal puncture is usually associated with impaired hemostasis. This case illustrates that it may occur in the absence of known risk factors. The delayed onset and the absence of risk factors have implications for the use of this procedure in chronic pain management.

Adult↗
PubMed1999

Epidural hematoma following epidural catheter placement in a patient with chronic renal failure.

PURPOSE: We report a case of epidural hematoma in a surgical patient with chronic renal failure who received an epidural catheter for postoperative analgesia. Symptoms of epidural hematoma occurred about 60 hr after epidural catheter placement. CLINICAL FEATURES: A 58-yr-old woman with a history of chronic renal failure was admitted for elective abdominal cancer surgery. Preoperative laboratory values revealed anemia, hematocrit 26%, and normal platelet, PT and PTT values. General anesthesia was administered for surgery, along with epidural catheter placement for postoperative analgesia. Following uneventful surgery, the patient completed an uneventful postoperative course for 48 hr. Then, the onset of severe low back pain, accompanied by motor and sensory deficits in the lower extremities, alerted the anesthesia team to the development of an epidural hematoma extending from T12 to L2 with spinal cord compression. Emergency decompressive laminectomy resulted in recovery of moderate neurologic function. CONCLUSIONS: We report the first case of epidural hematoma formation in a surgical patient with chronic renal failure (CRF) and epidural postoperative analgesia. The only risk factor for the development of epidural hematoma was a history of CRF High-risk patients should be monitored closely for early signs of cord compression such as severe back pain, motor or sensory deficits. An opioid or opioid/local anesthetic epidural solution, rather than local anesthetic infusion alone, may allow continuous monitoring of neurological function and be a prudent choice in high-risk patients. If spinal hematoma is suspected, immediate MRI or CT scan should be done and decompressive laminectomy performed without delay.

Analgesia, Epidural↗
PubMed2005

Spontaneous complete recovery of paraplegia caused by epidural hematoma complicating epidural anesthesia: a case report and review of literature.

STUDY DESIGN: Case report. SETTING: Tertiary referral spinal surgery center in South India. OBJECTIVES: To report a patient who developed epidural hematoma following epidural anesthesia causing acute paraplegia. Surgery was avoided due to concomitant gastrointestinal bleeding and poor general condition. Patient showed early signs of recovery with complete resolution of neurological deficits in 12 weeks. CONCLUSION: Surgery can be avoided in patients who show early signs of neurological recovery following epidural hematoma.

Aged↗
PubMedDate not supplied

Epidural hematoma following epidural analgesia in a patient receiving unfractionated heparin for thromboprophylaxis.

BACKGROUND AND OBJECTIVES: The practice of providing postoperative epidural analgesia for patients receiving deep venous thromboprophylaxis with unfractionated heparin is common. This case report is intended to heighten awareness of comorbid risk factors for epidural hematoma and to bring attention to the new ASRA consensus guidelines on the management of neuraxial anesthesia in the presence of standard heparin. CASE REPORT: A 79-year-old woman with apparently normal coagulation and receiving no antiplatelet agents required an abdominoperineal resection for recurrent squamous cell carcinoma of the anus. Approximately 2 hours after her preoperative dose of 5,000 U unfractionated heparin, an epidural catheter was placed on the third attempt. Subcutaneous heparin was subsequently administered every 12 hours. Her international normalized ratio became slightly elevated during surgery while the partial thromboplastin time and platelet count remained normal. The catheter was removed on postoperative day 3, 6 hours after the last dose of heparin. The patient developed signs of an epidural hematoma requiring surgical evacuation on postoperative day 4. The presence of previously undiagnosed spinal stenosis may have contributed to her symptoms. CONCLUSION: Management of postoperative epidural analgesia in the patient receiving thromboprophylaxis with unfractionated heparin requires appropriate timing of epidural insertion and removal, monitoring of coagulation status and vigilance.

Aged↗
PubMedDate not supplied

Epidural hematoma after epidural anesthesia in a patient with peripheral vascular disease. Case report.

BACKGROUND AND OBJECTIVES: Epidural hematoma is a severe, uncommon complication associated with epidural anesthesia in patients with peripheral vascular disease who require anticoagulant therapy. METHODS: An 84-year-old woman with acute left leg arterial ischemia underwent revascularization surgery under lumbar epidural anesthesia. Pre- and postoperative heparin was administered as an anticoagulant. RESULTS: Reperfusion of the leg was successful, however, 3 days later clinical signs of spinal cord compression appeared and epidural hematoma was diagnosed. Neurologic recovery was poor. CONCLUSIONS: This case highlights the need for careful individual preoperative analysis and postoperative observation to make anesthetic practice safe in patients receiving perioperative anticoagulant therapy.

Aged↗
PubMed2003

[Coincidence of an epidural hematoma and epidural metastases during thoracic epidural anaesthesia].

In the present report we describe a case of epidural hematoma with paraplegia subsequent to preoperative thoracic epidural catheter insertion. The hematoma co-localized with epidural metastases unknown at the time of catheter insertion. In addition to the description of the exact interventions, the conditions enabling early diagnosis and therapy of the described complication are discussed. Furthermore, we discuss the necessity of preoperative examinations if an epidural anaesthesia is planned.

Aged↗
PubMed1991

Spinal epidural hematoma following epidural anesthesia versus spontaneous spinal subdural hematoma. Two case reports.

Two cases of lumbar hemorrhage with subsequent persistent neurologic sequelae are presented and their possible causes are discussed in the context of a literature review: one patient with spontaneous spinal subdural hematoma with no trauma or lumbar puncture and one with spinal epidural hematoma associated with preceding epidural catheterization for postoperative pain relief. The subdural hematoma was associated with a thrombocytopenia of about 90,000/microliters due to intraoperative blood loss. This might have been contributory to the formation or expansion of the hematoma, but it is not convincing since a platelet count of this amount should not lead to spontaneous bleeding. Both patients received low-dose heparin, but since coagulation tests were normal, prolonged bleeding does not appear to be a likely cause, although it cannot be excluded. In conclusion, the reasons for both hematoma remain unclear. With regard to the epidural hematoma and low-dose heparinization, the possible coincidence of spontaneous lumbar hematoma and lumbar regional block should be taken into consideration.

Anesthesia, Epidural↗
PubMed1988

[Epidural hematoma following epidural catheter anesthesia in thrombocytopenia].

We report a 21-year-old male patient suffering from acute myeloid leukemia and concomitant thrombocytopenia. Following a diagnostic thoracotomy-which revealed Aspergillus pneumonia-he developed respiratory insufficiency and dyspnea. A thoracic epidural catheter was inserted and epidural morphine treatment led to improved ventilation. No clinical signs of pathological epidural processes were noticed during the treatment. The patient died of Aspergillus sepsis 26 days after catheter insertion. Autopsy revealed bacterial growth in the epidural space with slight infectious tissue reactions as well as an epidural hematoma. No evidence of spinal cord compression was found at autopsy. The development of epidural infection or hematoma seems to be a possible complication of epidural analgesia in patients suffering from impaired defense mechanisms or thrombocytopenia. These risk factors should be taken into account when epidural analgesia is considered. We suggest that the platelet count should be determined beforehand in patients suspected of having thrombocytopenia (e.g. cancer, pre-eclampsia).

Adult↗
PubMed2001

[Epidural lumbar hematoma, epidural anesthesia and low-molecular-weight heparins].

Epidural hematoma is an uncommon but serious complication of epidural anaesthesia. The use of low molecular weight heparin (LMWH) as thromboprophylaxis has increased the occurrence of this pathology. We report the case of a 81-year-old man who underwent an arthroscopy of the knee, with epidural anaesthesia and administration of LMWH. The patient suffered an important pain due to a lumbar epidural haematoma which was diagnosed by magnetic resonance, after withdrawal of the epidural catheter. He improved after surgical evacuation, and no neurological deficit was present. We comment the association of LMWH, epidural anaesthesia and epidural haematoma.

Aged↗
PubMed1981

[Postoperative epidural hematoma - five case of epidural hematomas developed after supratentorial craniotomy on the contralateral side (author's transl)].

Postoperative epidural hematomas developed far from the operative field are generally recognized as a complication of ventriculo-peritoneal shunt, ventricular drainage or suboccipital craniotomy. It is very rare but may occur after supratentorial craniotomy on the contralateral side. Five such cases are presented with a review of the relevant literature. The mechanism of this complication is not clearly understood. In hydrocephalus, these massive epidural hematomas are probably caused by dura-skull detachment when the brain volume is strikingly reduced by a decompressive procedure. On rare occasions, pins of head rest may detach the dura and cause epidural hematomas. When sudden brain swelling during craniotomy is encountered, attention should be directed not only to intracerebral hemorrhage but also epidural hematoma developed on the contralateral side.

Adult↗
PubMed2004

[Epidural hematoma after an epidural block in a patient with no coagulopathy].

We report a case of epidural hematoma after a single epidural block. The patient was a 67-year-old woman with sciatica and osteoarthritis of the spine. She had no coagulopathy. She underwent a single epidural block without difficulty 3 times in 5 days. She had a lumbar MRI for an examination of the spine 4 days after the final epidural block. Subacute epidural hematoma of 0.8 x 1.5 x 3.0 cm was revealed on MRI at L 3-4. She had no new neurological symptoms. MRI 1 month later revealed a resolution of the hematoma. Epidural hematoma after an epidural block might occur in an outpatient with no bleeding tendency.

Acute Disease↗
PubMed1992

[Subdural and epidural hematomas following epidural anesthesia. A literature review].

Of 434 cases of epidural, subdural, and intracranial haematomas published in the last 2-3 decades, 61 had developed following spinal, epidural or caudal anaesthetic procedures; 29 haematomas were around the spinal cord and 32, within the cranium. The most frequent secondary cause of this complication was pre-, intra-, or postoperative administration of drugs influencing blood coagulation. Simultaneous traumatic and haemorrhagic punctures may favour the development of a haematoma. The most common primary symptom of lumbothoracic haematomas was back pain with and without radicular symptoms, while intracranial haematomas were predominantly accompanied by persistent headache. Continuous postoperative follow-up of such patients is essential. Postoperative results of laminectomies for lumbothoracic haematomas has been found to on the time interval between the first symptoms and the start of surgery. If surgery is performed within 8 h after the onset of paraplegia the prognosis is relatively good. Compared with the frequency of spinal, epidural, and caudal anaesthetic procedures throughout the world, haematomas of the lumbothoracic or cranial region are extremely rare complications.

Adult↗