Spinal-Epidural Hematoma after Spinal Anesthesia: a Case Report

Authors

  • Numphung Sukantarat Division of Anesthesiology, Chomthong Hospital, Chiangmai 50160, Thailand

Keywords:

postoperative complication, spinal anesthesia, spinal-epidural hematoma

Abstract

Spinal anesthesia is commonly used to manage pain during and after limb surgery. Despite its general safety, it can lead to a serious complication known as postoperative spinal-epidural hematoma, which poses risks of severe morbidity or even mortality. I report a case of a patient who developed an acute lumbar epidural hematoma after receiving spinal anesthesia.

References

Benzon HT JR, Zundert TCV. Neuraxial anesthesia & peripheral nerve blocks in patients on anticoagulants. A H, editor: McGraw-Hill Education; 2017.

Glotzbecker MP, Bono CM, Wood KB, Harris MB. Postoperative spinal epidural hematoma: a systematic review. Spine. 2010;35:E413-20.

Liu H, Brown M, Sun L, et al. Complications and liability related to regional and neuraxial anesthesia. Best Pract Res Clin Anaesthesiol. 2019;33:487-97.

Kreppel D, Antoniadis G, Seeling W. Spinal hematoma: a literature survey with meta-analysis of 613 patients. Neurosurg Rev. 2003;26:1-49.

Caputo AM, Gottfried ON, Nimjee SM, Brown CR, Michael KW, Richardson WJ. Spinal epidural hematoma following epidural steroid injection in a patient treated with dabigatran: a case report. JBJS Case Connect. 2013;3(Suppl9):e64.

Messerer M, Dubourg J, Diabira S, Robert T, Hamlat A. Spinal epidural hematoma: not always an obvious diagnosis. Eur J Emerg Med. 2012;19:2-8.

Awad JN, Kebaish KM, Donigan J, Cohen DB, Kostuik JP. Analysis of the risk factors for the development of post-operative spinal epidural haematoma. J Bone Joint Surg Br. 2005;87:1248-52.

Han IS, Chung EY, Hahn YJ. Spinal epidural hematoma after epidural anesthesia in a patient receiving enoxaparin -a case report. Korean J Anesthesiol. 2010;59:119-22.

Lawton MT, Porter RW, Heiserman JE, Jacobowitz R, Sonntag VK, Dickman CA. Surgical management of spinal epidural hematoma: relationship between surgical timing and neurological outcome. J Neurosurg. 1995;83:1-7.

Torres A, Acebes JJ, Cabiol J, et al. Spinal epidural hematomas. Prognostic factors in a series of 22 cases and a proposal for management. Neurocirugia. 2004;15:353-9.

Dziedzic T, Kunert P, Krych P, Marchel A. Management and neurological outcome of spontaneous spinal epidural hematoma. J Clin Neurosci. 2015;22:726-9.

Siasios ID, Vakharia K, Gibbons KJ, Dimopoulos VG. Large, spontaneous spinal subdural-epidural hematoma after epidural anesthesia for caesarean section: conservative management with excellent outcome. Surg Neurol Int. 2016;7(Suppl 25):S664-7.

Svelato A, Rutili A, Bertelloni C, Foti D, Capizzi A, Ragusa A. Case report: difficulty in diagnosis of delayed spinal epidural hematoma in puerperal women after combined spinal epidural anaesthesia. BMC Anesthesiol. 2019;19:54.

Fang M, Zhou J, Yang D, et al. Management and outcomes of spinal epidural hematoma during vertebroplasty: case series. Medicine. 2018;97:e10732.

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Published

2025-05-02

How to Cite

Sukantarat , N. (2025). Spinal-Epidural Hematoma after Spinal Anesthesia: a Case Report. Thai Journal of Anesthesiology, 51(3), 187–192. retrieved from https://he02.tci-thaijo.org/index.php/anesthai/article/view/275226

Issue

Vol. 51 No. 3 (2025): May-June

Section

Case reports

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