Sondekoppam Rakesh V, Quan Douglas, Ganapathy Sugantha
From the *Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada; †Department of Surgery, and ‡Department of Anesthesiology and Perioperative Medicine, Western University, London, Ontario, Canada.
A A Case Rep. 2017 Aug 15;9(4):123-126. doi: 10.1213/XAA.0000000000000544.
Spinal epidural hematoma (SEH) following neuraxial anesthesia needs prompt recognition and early decompressive measures to prevent long-term neurologic injury. We report a case of SEH presenting on the second postoperative day during an ongoing epidural infusion. Aspiration of blood through the epidural catheter and a subsequent improvement in the neurological symptoms made us suspect SEH, which was further confirmed by an MRI study. We describe the timeline of the presentation of SEH and the subsequent clinical course in our patient. Aspiration of blood through an in situ epidural catheter may not only point toward the possibility of SEH but may also temporarily decompress the spinal canal.
椎管内麻醉后发生的脊髓硬膜外血肿（SEH）需要及时识别并尽早采取减压措施，以防止长期神经损伤。我们报告一例在持续硬膜外输注期间术后第二天出现的SEH病例。通过硬膜外导管抽吸出血液以及随后神经症状的改善使我们怀疑为SEH，这一怀疑通过磁共振成像（MRI）研究得到进一步证实。我们描述了该患者SEH的出现时间线及随后的临床病程。通过原位硬膜外导管抽吸血液不仅可能提示SEH的可能性，还可能暂时使椎管减压。
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