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ISSN: 2165-7548

Emergency Medicine: Open Access
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Case Report

Spinal Epidural Hematoma Following Epidural Anesthesia Managed Safely Without Surgery: A Case Report

Hiroshi Tsujikawa1,2*, Masahiro Kakuyama1, Kazuhiko Fukuda1

1Department of Critical Care Medicine, Kyoto University Hospital, Kyoto, Sakyo-ku 606-8507, Japan

2Department of Anesthesia, Uji-Tokushukai Medical Center, 86, Kasugamori, Ogura-cho, Uji-city, Kyoto 611- 0042, Japan

*Corresponding Author:
Hiroshi Tsujikawa
Department of Anesthesia
Uji-Tokushukai Medical Center 86, Kasugamori
Ogura-cho, Uji-city, Kyoto 611-0042, Japan
E-mail: [email protected]

Received Date: May 15, 2013; Accepted Date: October 08, 2013; Published Date: October 10, 2013

Citation: Tsujikawa H, Kakuyama M, Fukuda K (2013) Spinal Epidural Hematoma Following Epidural Anesthesia Managed Safely Without Surgery: A Case Report. Emergency Med 3:156 doi:10.4172/2165-7548.1000156

Copyright: © 2013 Tsujikawa H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Spinal Epidural Hematoma (SEH) is known to occur as a complication of invasive spinal procedures, such as epidural anesthesia, and can cause dramatic neurologic deficits if not diagnosed and treated immediately. The present report describes the case of a gynecologic patient who presented with weakness and numbness of both lower limbs soon after an epidural test bolus was injected. Urgent magnetic resonance imaging of the thoracic spine demonstrated an epidural hematoma at T12/L1 with slight spinal cord compression. The patient demonstrated significant improvement in neurologic deficits within a short time. Therefore, general anesthesia was induced, and the scheduled operation was performed uneventfully. After the operation, the patient had no detectable neurologic abnormality, and repeat imaging showed almost complete resolution of the hematoma. Although urgent decompression is the treatment of choice for SEH, conservative management may be indicated if the patient demonstrates rapidly improving neurologic deficits.


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