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Epidural Hematoma

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1. Spontaneous cervical epidural hematoma mimicking a transient ischemic attack Full Text available with Trip Pro

Spontaneous cervical epidural hematoma mimicking a transient ischemic attack 30338089 2018 11 14 2052-8817 5 4 2018 Oct Acute medicine & surgery Acute Med Surg Spontaneous cervical epidural hematoma mimicking a transient ischemic attack. 395-396 10.1002/ams2.350 Kudo Shunsuke S 0000-0002-7174-7174 Department of Emergency and Critical Care Medicine Saku Central Hospital Advanced Care Center Saku Nagano Japan. Soma Mayuko M Department of Emergency and Critical Care Medicine Saku Central Hospital

2018 Acute medicine & surgery

2. Case report: difficulty in diagnosis of delayed spinal epidural hematoma in puerperal women after combined spinal epidural anaesthesia. Full Text available with Trip Pro

Case report: difficulty in diagnosis of delayed spinal epidural hematoma in puerperal women after combined spinal epidural anaesthesia. Spinal epidural hematoma is a rare but serious complication of epidural anaesthesia and neurological impairment. Epidural hematoma usually becomes evident within a few hours of the procedure. Delayed clinical presentation of spinal epidural hematoma is even rarer and insidious.We reported a case of a 44-year-old woman who underwent a caesarean section (...) for a twin pregnancy during which a delayed dorsal spinal epidural hematoma occurred. Symptoms were reported 5 days after surgery and 72 h after removal of the epidural catheter. An MRI scan showed a dorsal epidural hematoma. The patient was moved to the Neurosurgical Department and underwent decompression surgery.The possibility of the delayed onset of a spinal epidural hematoma in a pregnant woman who undergoes epidural anaesthesia in labour must always be taken into consideration. In order to achieve

2019 BMC Anesthesiology

3. Spinal epidural hematoma occurring at a distance from the transforaminal epidural injection site: A case report. Full Text available with Trip Pro

Spinal epidural hematoma occurring at a distance from the transforaminal epidural injection site: A case report. Transforaminal epidural steroid injection (TFESI) is a conservative method to treat back pain due to radiculopathy. However, epidural hematoma can occur after the procedure by various mechanisms, which can cause serious complications.An 82-year-old man with spinal stenosis was treated with TFESI in the right intervertebral foramen at the L2-L3 level. The next morning, he experienced (...) severe back pain and diffuse motor deficit.Emergency magnetic resonance imaging revealed fluid collection in the posterior epidural space at the T11-L1 level with central-canal stenosis.Emergency hematoma evacuation was performed to remove the epidural hematoma.After the surgery, the back pain disappeared.Epidural hematoma may occur due to causes other than direct needle injury after TFESI. Therefore, careful observation of the patient is necessary after the procedure.

2019 Medicine

4. Cervical epidural hematoma following interlaminar epidural steroid injection via the contralateral oblique view in patient taking omega-3 fatty acids. (Abstract)

Cervical epidural hematoma following interlaminar epidural steroid injection via the contralateral oblique view in patient taking omega-3 fatty acids. We sought to describe a case of an epidural hematoma after a cervical interlaminar epidural steroid injection (ILESI) performed using contralateral oblique view. We also discuss factors that could have placed this patient at increased risk, including concurrent use of omega-3 fatty acids and non-steroidal anti-inflammatory medications.A 74-year (...) -old woman returned to the pain clinic, within 15 min of discharge, after an apparent uncomplicated cervical ILESI using the contralateral oblique technique with severe periscapular pain and muscle spasms. Cervical MRI showed a large epidural hematoma which was subsequently emergently evacuated. On postoperative examination, the patient had no neurologic deficits and full resolution of her painful symptoms.To our knowledge, this is the first reported case of cervical epidural hematoma in which

2019 Regional Anesthesia and Pain Medicine

5. Spontaneous spinal epidural hematoma management: a case series and literature review Full Text available with Trip Pro

Spontaneous spinal epidural hematoma management: a case series and literature review Spontaneous spinal epidural hematoma (SSEH) manifests from blood accumulating in the epidural space, compressing the spinal cord and leading to acute neurological deficits. Standard therapy is decompressive laminectomy, although spontaneous recoveries have been reported. Sub-optimal therapeutic principles contribute to SSEH's 5.7% mortality-which patient will benefit from surgery remains unclear. This study

2017 Spinal cord series and cases

6. Two cases of spontaneous cervical epidural hematoma without back or neck pain in elderly Japanese men Full Text available with Trip Pro

Two cases of spontaneous cervical epidural hematoma without back or neck pain in elderly Japanese men Spontaneous spinal epidural hematoma (SSEH) is an uncommon disease. Most SSEH cases involve back and/or neck pain. We report the cases of two men who experienced SSEH with dysstasia but without back or neck pain.This study presents two cases involving elderly Japanese men who visited an emergency department because of sudden dysstasia without back or neck pain. The results of the neurological (...) examinations revealed ataxic gait. Cervical spinal epidural hematomas were observed by computed tomography and magnetic resonance imaging. One patient underwent hematoma removal and decompression by corpectomy, whereas the other patient received conservative treatment and observation. The patients were discharged without sequelae.Spinal epidural hematomas are difficult to diagnose, and a delayed diagnosis can adversely affect the patient's quality of life. These hematomas should be considered

2017 Acute medicine & surgery

7. Spontaneous Absorption of a Lumbar Epidural Hematoma after Interlaminar Epidural Steroid Injection in a Patient with Spinal Stenosis: Close Observation as a Treatment Strategy Full Text available with Trip Pro

Spontaneous Absorption of a Lumbar Epidural Hematoma after Interlaminar Epidural Steroid Injection in a Patient with Spinal Stenosis: Close Observation as a Treatment Strategy 29271396 2018 12 11 2018 12 11 2542-5641 131 1 2018 01 05 Chinese medical journal Chin. Med. J. Spontaneous Absorption of a Lumbar Epidural Hematoma after Interlaminar Epidural Steroid Injection in a Patient with Spinal Stenosis: Close Observation as a Treatment Strategy. 117-118 10.4103/0366-6999.221276 Kim Soo Hyang SH (...) China Chin Med J (Engl) 7513795 0366-6999 0 Steroids IM Hematoma, Epidural, Cranial Hematoma, Epidural, Spinal drug therapy etiology Humans Lumbar Vertebrae Lumbosacral Region Spinal Stenosis complications Steroids administration & dosage Treatment Outcome 2017 12 23 6 0 2017 12 23 6 0 2018 12 12 6 0 ppublish 29271396 ChinMedJ_2018_131_1_117_221276 10.4103/0366-6999.221276 PMC5754952 Reg Anesth Pain Med. 2010 Jan-Feb;35(1):64-101 20052816 Korean J Pain. 2013 Jan;26(1):76-9 23342213 Pain Pract. 2014

2018 Chinese medical journal

8. Epidural Hematoma Following Interlaminar Epidural Injection in Patient Taking Aspirin. (Abstract)

Epidural Hematoma Following Interlaminar Epidural Injection in Patient Taking Aspirin. We present a case report of a patient who developed an epidural hematoma following an interlaminar epidural steroid injection with no risk factors aside from old age and aspirin use for secondary prevention.A 79-year-old man developed an epidural hematoma requiring surgical treatment following an uncomplicated interlaminar epidural steroid injection performed for neurogenic claudication. In the periprocedural

2018 Regional Anesthesia and Pain Medicine

9. Epidural hematoma after caudal epidural pulsed radiofrequency stimulation: A case report. Full Text available with Trip Pro

Epidural hematoma after caudal epidural pulsed radiofrequency stimulation: A case report. Epidural hematoma is a possible complication after neuraxial procedures. Recently, caudal epidural pulsed radiofrequency (PRF) stimulation was reported as an effective method for controlling several types of chronic pain. Herein, we report on a patient who developed a lumbar epidural hematoma after receiving caudal epidural PRF stimulation.A 75-year-old woman, who was taking oral warfarin (2 mg/d (...) ), received caudal epidural PRF stimulation for symmetrical neuropathic pain in both legs due to chronic idiopathic axonal polyneuropathy. She did not discontinue warfarin use before undergoing the procedure. Three days and 12 hours after the procedure, motor weakness suddenly manifested in the right leg (manual muscle testing [MMT] = 2-3).Lumbar magnetic resonance imaging (MRI) performed 7 days after the PRF procedure showed a spinal epidural hematoma at the L1 to L5 levels, compressing the thecal sac

2018 Medicine

10. Traumatic Retroclival Epidural Hematoma. (Abstract)

Traumatic Retroclival Epidural Hematoma. Retroclival epidural hematomas are particularly rare conditions that are frequently the result of high-energy, hyperflexion-hyperextension injuries in pediatric patients. We present the case of a 7-year-old previously healthy girl with traumatic retroclival epidural hematoma after a fall from a swing. She presented with a Glasgow Coma Scale score of 15 with severe neck pain and limitation of cervical movements in all directions. Radiological examination (...) revealed retroclival epidural hematoma, and the patient was managed conservatively with good recovery. Although conservative management leads to good recovery in most cases, retroclival epidural hematomas should always be kept in mind regardless of the severity of trauma.

2019 Pediatric Emergency Care

11. Plasmacytoma of the skull mimicking an epidural hematoma: A case report. Full Text available with Trip Pro

Plasmacytoma of the skull mimicking an epidural hematoma: A case report. Plasmacytoma as the 1st presentation of skull tumors is a rare disorder. When it is combined with brain trauma or dramatic changes in intracranial pressure, patients are more prone to misdiagnosis.A 67-year-old woman complaining of a headache presented with a history of head trauma for the past 1 hour. Emergency head computed tomography initially suggested an epidural hematoma.Emergency surgery was performed to remove (...) the intracranial hematoma, but a tumor-like mass was found during surgery, and pathologic assessment confirmed plasmacytoma. Surgery was difficult because of bleeding. The tumor was radically removed.The patient underwent whole-brain radiotherapy and chemotherapy. She died 40 months after the surgery.Epidural lesions found after a head injury may be assumed to be an epidural hematoma, leading to unnecessary surgery. Diseases such as hematomas, meningiomas, eosinophilic granulomas, bone metastases

2019 Medicine

12. Traumatic lumbar disc herniation mimicking epidural hematoma: A case report and literature review. Full Text available with Trip Pro

Traumatic lumbar disc herniation mimicking epidural hematoma: A case report and literature review. We report a rare case of traumatic lumbar disc herniation mimicking epidural hematoma.A 39-year old man presented with acute bilateral leg and back pain, following a crushing injury caused by a crane collapse.A computed tomography scan revealed multiple compression fractures of the thoracolumbar spine, including a burst fracture of the L4 vertebral body. Magnetic resonance imaging (MRI) showed (...) an epidural mass, extending longitudinally and causing dural sac compression behind the L3 vertebra. The mass had isosignal intensity on T1-weighted imaging and showed mixed high and low signals on T2-weighted imaging. On the basis of the patient's clinical history and imaging findings, our provisional diagnosis was an epidural hematoma following major trauma.An emergency L3 laminectomy was performed with percutaneous screw fixation of L3-5. Intraoperatively, 3 large herniated disc fragments were found

2019 Medicine

13. Recovery of paraplegia following postoperative epidural hematomas in lumbar canal stenosis surgery by closed kinetic chain (CKC) exercises: A case report. Full Text available with Trip Pro

Recovery of paraplegia following postoperative epidural hematomas in lumbar canal stenosis surgery by closed kinetic chain (CKC) exercises: A case report. A postoperative spinal epidural hematoma (PSEH) is among the most devastating complications following spine and spinal cord surgery, and it should be considered before performing microendoscopic decompression as part of minimally invasive surgery, since early recovery is one of the advantages of this procedure.A 70-year-old woman with lumbar (...) spinal stenosis at L4-5 underwent tubular surgery with the assistance of endoscopic laminectomy (MEL), but 2 days after the surgery, the patient noticed decreased lower limb sensation and power of the right leg, and she developed numbness from the level of L5 and weakness from the L4, 5 myotome distally.An epidural hematoma at the L4-5 surgical site was found on magnetic resonance imaging of the lumbar spine and evacuated operatively. This rare complication appears to be the result of a PSEH

2019 Medicine

14. A Spontaneous Cervical Epidural Hematoma Mimicking a Stroke: A Challenging Case. (Abstract)

A Spontaneous Cervical Epidural Hematoma Mimicking a Stroke: A Challenging Case. A spontaneous cervical epidural hematoma (SCEH) is a rare occurrence, with < 500 cases reported to date. Clinically, it usually presents with quadriparesis, but in extremely rare cases it can present with hemiparesis or hemiplegia, and can easily be misdiagnosed as stroke. The cervical epidural hematoma by itself is an urgent condition that requires a quick and accurate diagnosis and a prompt surgical treatment.We

2019 Journal of Emergency Medicine

15. Atraumatic Spinal Epidural Hematoma as Initial Presentation of Hemophilia A in an Infant. (Abstract)

Atraumatic Spinal Epidural Hematoma as Initial Presentation of Hemophilia A in an Infant. Hemophilia A is characterized by deficiency of factor VIII. We present a unique, illustrative case of an infant with a short history of neck pain and irritability without neurological deficits who was found to have a spinal epidural hematoma. The subsequent investigation for the etiology, including workup for nonaccidental trauma, led to a diagnosis of severe hemophilia A.

2019 Pediatric Emergency Care

16. Massage-induced spinal epidural hematoma presenting with delayed paraplegia. (Abstract)

Massage-induced spinal epidural hematoma presenting with delayed paraplegia. Spinal epidural hematoma (SEH) is an uncommon but serious emergency condition rare cases of spontaneously or following a minor traumatic event without bony injury.We report the rare case of SEH associated with traditional massage initially presenting with delayed lower paraplegia.A 20-year-old man presented with bilateral lower extremity weakness and numbness 3 h prior to presentation. 3 days prior he was given (...) a layperson Thai massage by a friend. Magnetic resonance imaging revealed a spinal epidural lesion suspicious for hematoma extending from C6 to T2 levels. Emergent surgical intervention for cord decompression was performed. An epidural hematoma with cord compression at C6-T2 levels was identified intraoperatively. No evidence of abnormal vascular flow or AV malformations was identified. Similar to chiropractic manipulation, massage may be associated with spinal trauma.Emergency physicians must maintain

2019 American Journal of Emergency Medicine

17. Spontaneous spinal epidural haematomas in children. (Abstract)

Spontaneous spinal epidural haematomas in children. To understand the typical presentation, risk factors, location and size, treatment, neurological recovery and survival of spontaneous spinal epidural haematomas (SSEH) in children.A systematic review of the English literature from 1 January 1960 to 1 March 2018 was performed on children aged 18 years and younger. Individual patient data were extracted and collated. Outcome measures were mode of presentation, risk factors, initial neurological (...) and/or CT scan confirming the diagnosis. The cervical-thoracic region was most commonly affected, and the average haematoma size extended across 6.3 vertebral levels. Surgical decompression was performed in 72% of patients. Neurological function improved in 83% of patients. Two patients died as a consequence of their SSEH.SSEHs affect all paediatric age groups and typically present with neurological dysfunction and/or back pain. The initial diagnosis is incorrect in up to 28% of cases, but cross

2019 European Spine Journal

18. A rare case of deep cerebral venous thrombosis secondary to traumatic epidural hematoma: Case report. Full Text available with Trip Pro

A rare case of deep cerebral venous thrombosis secondary to traumatic epidural hematoma: Case report. Deep cerebral venous thrombosis (DCVT) is a rare disease, but always results in poor prognosis.We reported a 79-year-old female with coma after traumatic brain injury (TBI).The epidural hematoma was first diagnosed on non-contrast computerized tomography (CT). The hypodense areas in bilateral thalami and basal ganglia on reexamination CT highly indicated the suspicion of DCVT. Finally (...) , the appearance of thrombosis of the vein of Galen on the computed tomography venography (CTA) and digital subtraction angiography (DSA) confirmed the diagnosis.The patients received surgery to remove the epidural hematoma. After that, she was treated with oral anticoagulation agent (low molecular weight heparin (LMWH), 180 Axal U/kg 24 h) for 4 weeks, shifted by oral warfarin (2.5 mg qd) for 4 weeks.The hypodense areas in bilateral thalami and basal ganglia have been largely reversed. At the time of 6 months

2018 Medicine

19. Repeat Head CT for Expectant Management of Traumatic Epidural Hematoma. Full Text available with Trip Pro

Repeat Head CT for Expectant Management of Traumatic Epidural Hematoma. Guidelines regarding the role of repeated head computed tomography (CT) imaging in the nonoperative management of traumatic epidural hematomas (EDHs) do not exist. Consequently, some children may be exposed to unnecessary additional ionizing radiation. We describe the frequency, timing, and utility of reimaging of EDHs to identify patients who might avoid reimaging.A retrospective cohort study of subjects aged 0 to 18 years

2018 Pediatrics

20. Impact of lumbar hypolordosis on the incidence of symptomatic postoperative spinal epidural hematoma after decompression surgery for lumbar spinal canal stenosis. (Abstract)

Impact of lumbar hypolordosis on the incidence of symptomatic postoperative spinal epidural hematoma after decompression surgery for lumbar spinal canal stenosis. Potential associations between radiographic parameters and the incidence of symptomatic postoperative spinal epidural hematoma (PSEH) have not been identified. This study aimed to identify risk factors including radiographic parameters for symptomatic PSEH after posterior decompression surgery for lumbar spinal canal stenosis (LSS).We

2018 European Spine Journal

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