Emergency Medicine: Open Access
Open Access

Abstract

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

Hiroshi Tsujikawa, Masahiro Kakuyama and Kazuhiko Fukuda

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.