Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA 94143-0648, USA.
Anesth Analg. 2010 Oct;111(4):992-5. doi: 10.1213/ANE.0b013e3181effd8f. Epub 2010 Jul 30.
Timely recognition and surgical decompression are crucial to minimize risk of permanent neurologic deficit from epidural hematoma. We present the case of a patient who developed acute back pain, sensory deficit, and ascending weakness 9 days after removal of a labor epidural catheter. Magnetic resonance imaging revealed a heterogeneous fluid collection extending from C6-7 through the lumbar region, with cord deformity at T9-11. Decompression laminectomy was performed within 4 hours of symptom onset. Twelve hours later, her motor function had fully recovered. Subsequent anatomic and hematologic workup was inconclusive. This presentation is atypical given the delayed presentation of symptoms after epidural placement.
及时识别和手术减压对于最大限度地降低硬膜外血肿导致永久性神经功能缺损的风险至关重要。我们报告了一例患者，其在移除分娩硬膜外导管 9 天后出现急性背痛、感觉缺失和进行性无力。磁共振成像显示从 C6-7 到腰椎区域存在不均匀的液体积聚，T9-11 处脊髓变形。在症状出现后 4 小时内进行了减压椎板切除术。12 小时后，她的运动功能完全恢复。随后的解剖和血液学检查结果不确定。鉴于硬膜外放置后症状延迟出现，这种表现是非典型的。
