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Review
. 2022 Apr 16;19(8):4845.
doi: 10.3390/ijerph19084845.

Spinal Intradural Hematoma after Spinal Anesthesia in a Young Male Patient: Case Report and Review of the Literature

Jae Young Ji  1 , Jae Min Ahn  2 , Jin Hun Chung  1 , Nan Seol Kim  1 , Yong Han Seo  1 , Ho Soon Jung  1 , Hea Rim Chun  1 , Woo Jong Kim  3 , Chan Ho Park  4 , Jeong Soo Choi  1 , Hyun Chul Jung  1 , Jin Soo Park  1
Affiliations
Review

Spinal Intradural Hematoma after Spinal Anesthesia in a Young Male Patient: Case Report and Review of the Literature

Jae Young Ji et al. Int J Environ Res Public Health. .

Abstract

Spinal intradural hematoma (SIH) is a rare condition which can cause neurological sequelae such as permanent motor weakness and sensory loss in the lower extremities. Herein, we describe a case of SIH following spinal anesthesia. The patient was a 30-year-old man who underwent treatment for accessory navicular syndrome at our department. The patient was not receiving anticoagulation therapy, and spinal anesthesia was thus selected. No symptoms of hematoma were observed in the immediate postoperative period, but the patient complained of pain in both buttocks on postoperative day 5. However, neither motor weakness nor sensory loss were observed. Additionally, as the radiating pain extending to the lower extremities typical of neurological pain was not observed, musculoskeletal pain was suspected. Magnetic resonance imaging revealed intradural hematomas at L4-5 and S1. Conservative treatment and follow-up evaluations were performed to ensure that additional neurological sequelae did not occur. Six months after symptom onset, his pain Numeric Rating Scale score was 0, and no other neurological findings were observed. However, in patients who undergo spinal anesthesia, localized pain in the back without other neurological symptoms and lack of radiating pain may be associated with more than musculoskeletal pain. Such patients must be continuously monitored.

Keywords: hematoma; magnetic resonance imaging; spinal; spinal anesthesia; young.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient’s accessory navicular bone (Arrow).
Figure 2
Figure 2
Hematoma (arrow) with a hyperintense signal at L4-5 and S1 on sagittal magnetic resonance imaging (MRI) (T1) on the left, and hematoma (arrow) with a hypointense signal on sagittal MRI (T2) on the right.
Figure 3
Figure 3
Hematoma (arrow) on the intradural side on magnetic resonance imaging (T2). In the horizontal section, the hematoma was observed on the spinal intradural side.
Figure 4
Figure 4
Magnetic resonance imaging (T2) showed a slight decrease in the size of the hematoma on the left side (arrow). The intradural hematoma on the right side was also decreased in size (arrow).
Figure 5
Figure 5
Flow diagram.
See this image and copyright information in PMC

References

    1. Avecillas-Chasin J., Matias-Guiu J.A., Gómez G., Saceda-Gutierrez J. A case of acute spinal intradural hematoma due to spinal anesthesia. J. Acute Dis. 2015;4:341–343. doi: 10.1016/j.joad.2015.06.015. - DOI
    1. Domenicucci M., Ramieri A., Paolini S., Russo N., Occhiogrosso G., Di Biasi C., Delfini R. Spinal subarachnoid hematomas: Our experience and literature review. Acta Neurochir. 2005;147:741–750. doi: 10.1007/s00701-004-0458-2. - DOI - PubMed
    1. Bruce-Brand R.A., Colleran G.C., Broderick J.M., Lui D.F., Smith E.M., Kavanagh E.C., Poynton A.R. Acute Nontraumatic Spinal Intradural Hematoma in a Patient on Warfarin. J. Emerg. Med. 2013;45:695–697. doi: 10.1016/j.jemermed.2013.04.048. - DOI - PubMed
    1. Maddali P., Walker B., Fisahn C., Page J., Diaz V., Zwillman M.E., Oskouian R.J., Tubbs R.S., Moisi M. Subdural Thoracolumbar Spine Hematoma after Spinal Anesthesia: A Rare Occurrence and Literature Review of Spinal Hematomas after Spinal Anesthesia. Cureus. 2017;9:e1032. doi: 10.7759/cureus.1032. - DOI - PMC - PubMed
    1. Jang W., Cho Y.-H., Lee D.-H., Kim S.-H. Subarachnoid hematoma after spinal anesthesia—A case report. Anesthesia Pain Med. 2018;13:154–157. doi: 10.17085/apm.2018.13.2.154. - DOI

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