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2015, Number 2

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Rev Mex Anest 2015; 38 (2)

Spinal subarachnoid hematoma secondary to spinal anesthesia. A case report

Martínez-Baeza OE, Ramos-Olmos CA, Durán-Melgoza A, Corona-Verduzco S, Chávez-López JA

Language: Spanish
References: 44
Page: 115-121
PDF size: 232.37 Kb.


ABSTRACT

Spinal subarachnoid hematoma is a rare complication secondary to neuraxial anesthesia. The severity of symptoms depends on the size, location and compressive effect. Early diagnosis with magnetic resonance and neurological exam will enable timely surgical treatment, although the prognosis is unfavorable. Described the case of a 33 year old man with renal failure, thrombocytopenia and metastatic spine injury who presented a subarachnoid spinal hematoma secondary to neuraxial anesthesia. Despite the delay in decompressive laminectomy, presented an exceptional neurological recovery. This case shows that despite comorbidities and poor prognosis of this type of hematoma, recovery depends on neurological deficit prior to decompressive laminectomy.


REFERENCES

  1. Checketts MR. Regional anaesthesia in patients taking anticoagulant drugs. Anaesthesia and Intensive Care Medicine. 2009;10:541-544.

  2. Horlocker TT, Wedel DJ, Rowlingson JC, Enneking FK, Kopp SL, Benzon HT, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy. American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Reg Anesth Pain Med. 2010;35:64-101.

  3. Bermejo M, Castañón E, Fervienza P, Cosío F, Carpintero M, Díaz-Fernández ML. Epidural hematoma secondary to spinal anesthesia. Conservative treatment. Rev Soc Esp Dolor. 2004;11:452-455.

  4. Horlocker TT. Complications of spinal and epidural anesthesia. Anesthesiology Clinics of North America. 2000;18:461-485.

  5. Carrillo R, Zaragoza G, Covarrubias A, Genis MA, Guadarrama V, Luna P, et al. Guía de práctica clínica para el manejo de la anestesia regional en el paciente que recibe anticoagulación y tromboprofilaxis. 2012;35:390S-424S.

  6. Reina MA, López A, De Andrés JA. Origen de los hematomas subdurales espinales. Estudio anatómico en cadáveres. Rev Esp Anestesiol Reanim. 2004;51:240-246.

  7. Martins N, Rodrigues R, Jordão JP. Recomendaciones de SBA para la seguridad en la anestesia regional en uso de anticoagulantes. Rev Bras Anestesiol. 2014;64:1-15.

  8. Vandermeulen E. Regional anaesthesia and anticoagulation. Best Practice & Research Clinical Anaesthesiology. 2010;24:121-131.

  9. Sánchez C, Alemán A, Coronado V, Jiménez P. Resolución espontánea de paraparesia por hematoma epidural dorsolumbar asociado a anestesia subaracnoidea y analgesia postoperatoria mediante catéter epidural. Rev Esp Anestesiol Reanim. 2012;59:503-506.

  10. Cullen DJ, Bogdanov E, Htut N. Spinal epidural hematoma occurrence in the absence of known risk factors: a case series. J Clin Anesth. 2004;16:376-381.

  11. Van Veen JJ, Nokes TJ, Makris M. The risk of spinal haematoma following neuraxial anaesthesia or lumbar puncture in thrombocytopenic individuals. British Journal of Haematology. 2009;148:15-25.

  12. Vandermeulen E, Decoster J, Dewandre PY, Ickx BE, Vercauteren M, Verhamme P. Central neural blockade in patients with a drug-induced alteration of coagulation Third edition of the Belgian Association for Regional Anaesthesia (BARA) Guidelines. Acta Anaesth Belg. 2011;62:175-191.

  13. Harrop-Griffiths W, Cook T, Gill H, Hill D, Ingram M, Makris M, Malhotra S, Nicholls B, Popat M, Swales H, Wood P. Regional anaesthesia and patients with abnormalities of coagulation. The Association of Anaesthetists of Great Britain & Ireland, The Obstetric Anaesthetists Association & Regional Anaesthesia UK. Anaesthesia. 2013;68:966-972.

  14. Dale MC, Checketts MR. Complications of regional anaesthesia. Anaesthesia and Intensive Care Medicine. 2013;14:142-145.

  15. Hoe W, Lim T, Yong P, Tan KK. Spinal epidural haematoma: MRI-aided diagnosis. Journal of Clinical Neuroscience. 2002;9:92-94.

  16. Fischer B. Complications of regional anaesthesia. Anaesthesia and Intensive Care Medicine. 2007;8:151-154.

  17. Walters MA, Van de Velde M, Wilms G. Acute intrathecal haematoma following neuraxial anaesthesia: diagnostic delay after apparently normal radiological imaging. Int J Obstet Anesth. 2012;21:181-185.

  18. Mullhi R, Moore P. Epidural and spinal anaesthesia and enhanced recovery: the anaesthetist’s contribution. Surgery. 2011;29:366-371.

  19. Lee CK. Epidural Hematomas in the setting of regional anesthesia: Diagnosis, Treatment, and Prevention. Seminars in Anesthesia, Perioperative Medicine and Pain. 2003;22(3):209-217.

  20. Howells ACL. Neurological complications in obstetric regional anaesthesia. Anaesthesia and Intensive Care Medicine. 2013;14:331-332.

  21. Gogarten W, Vandermeulen E, Van Aken H, Kozek S, Llau JV, Samama CM. Regional anaesthesia and antithrombotic agents: recommendations of the European Society of Anaesthesiology. Eur J Anaesthesiol. 2010;27:999-1015.

  22. Sagadai S, Panchagnula U, Sundararajan R, Quraishi T. Residual neurological deficit after central neuraxial blocks. Trends in Anaesthesia and Critical Care. 2012;2:180-190.

  23. Vinas FC, King PK, Liu YM, Johnson R, Diaz FG. Spinal cord changes after the evacuation of a spinal subdural haematoma. Journal of Clinical Neuroscience. 1999;6:57-61.

  24. Boukobza M, Haddar D, Boissonet M, Merland JJ. Spinal subdural haematoma: a study of three cases. Clinical Radiology. 2001;56:475-480.

  25. Landman UN, Jerome RM, Glass PSA. Subdural hematoma after atraumatic spinal. Journal of Clinical Anesthesia. 2005;17:379-381.

  26. Nayak PK, Das G, Parhi L, Mahapatra AK. Traumatic spinal extradural hematoma following epidural anesthesia. Indian Journal of Neurotrauma. 2009;6:95-96.

  27. Varela P, González J, Regueira M, Martínez P, Azevedo E. Hematomas espinales: la apoplejía espinal. Neurología. 2010;25(2):96-103.

  28. Urueña P, Ascencio JL, Riaño F. Hematomas espinales. Rev Colomb Radiol. 2013;24(1):3640-3647.

  29. Amiri AR, Fouyas IP, Cro S, Casey ATH. Postoperative spinal epidural hematoma (SEH): incidence, risk factors, onset, and management. The Spine Journal. 2013;13:134-140.

  30. Torres A, Acebes JJ, Cabiol J, Gabarrós A, López L, Plans G, Teixidor P. Revisión de 22 casos de hematomas epidurales espinales. Factores pronósticos y manejo terapéutico. Neurocirugía. 2004;15:353-359.

  31. Seow K, Drummond KJ. Subdural spinal haematoma after spinal anaesthesia in a patient taking aspirin. Journal of Clinical Neuroscience. 2011;18:1713-1715.

  32. Pavord S, Myers B. Bleeding and thrombotic complications of kidney disease. Blood Reviews. 2011;25:271-278.

  33. Mangiacapra F, Cavallari I, Barbato E, Ricottini E, Patti G, Vizzi V, et al. Impact of chronic kidney disease on platelet reactivity and outcomes of patients receiving clopidogrel and undergoing percutaneous coronary intervention. Am J Cardiol. 2014;113:1124-1129.

  34. Gonzalez-Fiol A, Eisenberger A. Anesthesia implications of coagulation and anticoagulation during pregnancy. Seminars in Perinatology. 2014;38:370-377.

  35. Choi S, Brull R. Neuraxial techniques in obstetric and non-obstetric patients with common bleeding diatheses. Anesth Analg. 2009;109:648-660.

  36. Pages-Arroyo E, Pian-Smith MCM. Neurologic complications of neuraxial anesthesia. Anesthesiology Clin. 2013;31:571-594.

  37. Koyama S, Tomimatsu T, Kanagawa T, Sawada K, Tsutsui T, Kimura T, et al. Spinal subarachnoid hematoma following spinal anesthesia in a patient with HELLP syndrome. Int J Obstet Anesth. 2010;19(1):87-91.

  38. Luo F, Cai XJ, Li ZY. Subacute spinal subarachnoid hematoma following combined spinal-epidural anesthesia treated conservatively: a case report. J Clin Anesth. 2012;24:519-520.

  39. Moscote LR, Lozano CF, Alcalá G, Villa R, Molina O. Hematoma epidural espinal en un joven con hemofilia: Reporte de caso. Revista Chilena de Neurocirugía. 2012;38:52-55.

  40. Braun P, Kazmib K, Nogués-Meléndez P, Mas-Estellés F, Aparici-Robles F. MRI findings in spinal subdural and epidural hematomas. European Journal of Radiology. 2007;64:119-125.

  41. Muñoz A, Cuello JP, Rodríguez PM, Iglesias AM, Domínguez R, Romero F, et al. Hematoma espinal epidural espontáneo: estudio retrospectivo de una serie de 13 casos. Neurología. 2014;1-8.

  42. Chang FC, Lirng JF, Luo CB, Yen YS, Guo WY, Teng MMH, Chang CY. Evaluation of clinical and MR findings for the prognosis of spinal epidural haematomas. Clinical Radiology. 2005;60:762-770.

  43. Heer JS, Enriquez EG, Carter AJ. Spinal epidural hematoma as first presentation of hemophilia A. The Journal of Emergency Medicine. 2008;34:159-162.

  44. Llau JV, Ferrandis R, García M. Anestesia locorregional, tromboprofilaxis y su relación con el desarrollo de hematoma espinal. Med Clin (Barc). 2003;121:414-417.




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