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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(02): 347-351
DOI: 10.1055/s-0043-1768576
Case Report

Spinal Subdural Hematoma following Epidural Anesthesia

Rajesh Bhosle
1   Department of Neurosurgery, National Neurosciences Centre, Kolkata, West Bengal, India
,
Dimble Raju
1   Department of Neurosurgery, National Neurosciences Centre, Kolkata, West Bengal, India
,
Shamshuddin Senior Patel
1   Department of Neurosurgery, National Neurosciences Centre, Kolkata, West Bengal, India
,
Grandhi Aditya
1   Department of Neurosurgery, National Neurosciences Centre, Kolkata, West Bengal, India
,
Jagriti Shukla
1   Department of Neurosurgery, National Neurosciences Centre, Kolkata, West Bengal, India
,
Nabanita Ghosh
1   Department of Neurosurgery, National Neurosciences Centre, Kolkata, West Bengal, India
,
Prasad Krishnan
1   Department of Neurosurgery, National Neurosciences Centre, Kolkata, West Bengal, India
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Abstract

The spinal subdural space is an avascular, potential space and is a rare location for intraspinal hematomas. Compared to spinal epidural hematomas, spinal subdural hematomas are uncommonly described complications of lumbar puncture for spinal or epidural anesthesia, particularly in patients who have no pre-existing bleeding disorders or history of antiplatelet or anticoagulant intake. We describe a 19-year-old girl who had a large thoracolumbar spinal subdural hematoma following epidural anesthesia for elective cholecystectomy with no pre-existing bleeding diathesis that caused rapidly developing paraplegia that evolved over the next 2 days following surgery. Nine days after the initial surgery she underwent multilevel laminectomy and surgical evacuation with eventual satisfactory recovery. Even epidural anesthesia without thecal sac violation can result in bleeding in the spinal subdural space. The possible sources of bleed in this space may be from injury to an interdural vein or extravasation of subarachnoid bleed into the subdural space. When neurological deficits occur, prompt imaging is mandatory and early evacuation yields gratifying results.

Keywords

lumbar puncture - epidural anesthesia - spinal subdural hematoma - laminectomy - complications

Informed Consent

Informed consent was received from the patient for this study.




Publication History

Article published online:
06 June 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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