Spontaneous spinal epidural hematoma (SSEH) after cesarean section under epidural anesthesia: A case report

作者全名："Wu, Hua; Huang, Xuezhu"

作者地址："[Wu, Hua; Huang, Xuezhu] Chongqing Med Univ, Women & Childrens Hosp, Chongqing Hlth Ctr Women & Children, Dept Anesthesiol, Chongqing, Peoples R China"

通信作者："Huang, XZ (通讯作者)，Chongqing Med Univ, Women & Childrens Hosp, Chongqing Hlth Ctr Women & Children, Dept Anesthesiol, Chongqing, Peoples R China."

来源：HELIYON

ESI学科分类：　

WOS号：WOS:001129817400001

JCR分区：Q1

影响因子：3.4

年份：2023

卷号：9

期号：12

开始页：　

结束页：　

文献类型：Article

关键词：Cesarean section; Case report; Epidural anesthesia; Labor analgesia; Spinal epidural hematoma

摘要："Spontaneous spinal epidural hematoma (SSEH) is an uncommon condition that can lead to severe neurological injuries, often accompanied by back pain. Pregnancy is identified as a risk factor for SSEH. Early diagnosis of SSEH presents challenges due to its atypical manifestations and the use of intraspinal anesthesia and analgesic techniques. In this case, we present the instance of a 29year-old woman who initially received epidural labor analgesia during the first stage of labor but subsequently required a cesarean section under epidural anesthesia according to amniotic fluid turbidity. Unfortunately, the anomalous recovery of neurological function in her left lower extremity was not given sufficient attention at an early stage, and paralysis in the non-puncture segment occurred 45.5 hours after the initial puncture. Interestingly, she did not experience any back pain during these procedures. MRI examination and consultation with neurosurgeons confirmed the diagnosis of SSEH, prompting the patient to undergo emergency decompression surgery. She made an incomplete recovery 17 months after the operation. This case emphasizes the importance of considering the possibility of SSEH in pregnant women undergoing epidural analgesia, highlighting the need for spinal imaging and early neurosurgical interventions to facilitate treatment."

基金机构：Beijing Health Alliance Charitable Foundation [KM-20230601-01]

基金资助正文："This study was supported by the Beijing Health Alliance Charitable Foundation: NO. KM-20230601-01. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."