SpontaneouS ReSolution of pReSumed acute epiduRal Hematoma foRmation afteR lumbaR epiduRal SteRoid injection
نویسنده
چکیده
A 76-year-old woman with mild lumbar spinal stenosis (L4-L5, L5-S1) and lumbar dextroscoliosis, previously on 81mg of aspirin daily (discontinued at 14 days prior to procedure) and not on anticoagulation therapy, underwent a lumbar epidural steroid injection (T12-L1). Post-procedurally, she developed bilateral leg paralysis. A magnetic resonance imaging (MRI) study revealed a fluid collection concerning for hematoma. Neurosurgery was consulted, but at the time of evaluation, she had near resolution of her presenting symptoms and the decision was made to monitor her for 48 hours. Three months after discharge, MRI revealed no persistent symptoms or radiographic evidence of sequelae from epidural hematoma. The frequency of spinal epidural hematomas after epidural steroid injections is unknown. This patient did not have traditional risk factors of severe spinal stenosis or the use of anticoagulant or antiplatelet agents. A radiographic fluid collection was seen, which may represent blood or persistent injectate. A formal surgical diagnosis was not obtained, as her symptoms spontaneously improved without further need for intervention.
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تاریخ انتشار 2017