一名患有血管性血友病患者在植入脊髓刺激器后发生延迟性硬膜外血肿：病例说明。
Delayed epidural hematoma after spinal cord stimulator implantation in a patient with von Willebrand disease: Illustration.
作者信息
Jaffee Stephen, Mamadhi Jyothika, Kite Trent, Kramer Dallas E, Tomycz Nestor
机构信息
Department of Neurosurgery, Allegheny Health Network, Pittsburgh, United States.
Department of Hematology/Oncology, Allegheny Health Network, Pittsburgh, United States.
出版信息
Surg Neurol Int. 2025 Jun 6;16:227. doi: 10.25259/SNI_311_2025. eCollection 2025.
BACKGROUND
A patient with von Willebrand disease developed a delayed epidural hematoma originating from the tunneling tract and gluteal generator pocket following the placement of a thoracic spinal cord stimulator (SCS).
CASE DESCRIPTION
A 43-year-old male with von Willebrand disease underwent thoracic SCS placement to treat chronic bilateral lower extremity pain with paresthesias in 2024. The patient had previously experienced a postoperative hematoma in 2010. At the time of the thoracic SCS placement, he received 7 days of prophylactic antihemophilic factor/von Willebrand factor complex therapy. One month following placement of the thoracic SCS, the patient noted significant swelling localized to the thoracic and buttock incisions. Exploratory surgery documented an additional hematoma tracking from the tunneling tract and gluteal generator pocket all the way into the epidural space; it was promptly removed. At the 6-month follow-up, he exhibited no further wounds or neurological issues.
CONCLUSION
Patients with coagulopathies, and critically, von Willebrand disease, undergoing SCS placement are at increased risk for postoperative hematomas.
背景
一名患有血管性血友病的患者在植入胸段脊髓刺激器（SCS）后，出现了起源于隧道通路和臀肌发生器囊袋的迟发性硬膜外血肿。
病例描述
一名43岁患有血管性血友病的男性于2024年接受胸段SCS植入术，以治疗慢性双侧下肢疼痛伴感觉异常。该患者曾在2010年经历过术后血肿。在进行胸段SCS植入时，他接受了7天的预防性抗血友病因子/血管性血友病因子复合物治疗。胸段SCS植入后一个月，患者注意到胸部和臀部切口处明显肿胀。 exploratory手术记录显示，有一个额外的血肿从隧道通路和臀肌发生器囊袋一直延伸到硬膜外间隙；该血肿被迅速清除。在6个月的随访中，他没有出现进一步的伤口或神经问题。
结论
患有凝血病，尤其是血管性血友病的患者，在接受SCS植入时术后发生血肿的风险增加。
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