Spontaneous spinal epidural hematoma in a pregnant patient

Journal of Clinical Anesthesia
Jacek B CywinskiLeonardo J Lozada

Abstract

Spontaneous spinal epidural hematoma is a rare occurrence during pregnancy with only five cases described in the literature since 1900. Even in the general population, the frequency of spontaneous spinal epidural hematoma is extremely low and the etiology unclear. Several theories exist for the cause of spontaneous spinal epidural hematoma, however, none has gained uniform acceptance. A case of spontaneous spinal epidural hematoma during pregnancy in a 27-year-old, gravida 2, para 1, female at term with 36 hours duration of both paresthesia and progressive weakness of the lower extremities is presented. In addition, all previous known cases are summarized, including outcome. We hypothesize that the cause of spontaneous spinal epidural hematoma is multifactorial, and pregnancy-induced structural changes in arterial walls and hemodynamic changes may play a role. In addition, we postulate that the origin of the bleeding is arterial, rather then venous. Lastly, the symptoms, diagnosis, and management of spontaneous spinal epidural hematoma during pregnancy are discussed.

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Citations

Jun 22, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Peng WangBo Liu
Jun 14, 2012·Journal of Medical Case Reports·Hisako FujimakiMasashi Takaso
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Sep 14, 2011·Spine·Ken Lee PuahSeang Beng Tan
May 12, 2009·The Neurologist·Dara G Jamieson, Maryna Skliut
Aug 2, 2017·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·C W Kong, William W K To
Jun 27, 2017·Journal of Medical Case Reports·Mehdi SamaliCharki Haimeur

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