Barontini F, Conti P, Marello G, Maurri S
Clinica Neurologica III, Università di Firenze, Italy.
Ital J Neurol Sci. 1996 Oct;17(5):333-9. doi: 10.1007/BF01999895.
We here report the major permanent neurological complications that developed in three patients after epidural anesthesia. MR clearly showed that paraplegia, which arose one and nine days after anesthesia, was due to epi-subdural haematoma in the first case and epidural abscess in the second. The sudden left lower limb palsy in the third patient was caused by a paracentral ischemic lesion all along the conus-epiconus following a probable trauma of the cord during the insertion of the needle. Despite the fact that this was reported to have been performed at L1-L2, an erroneous introduction into the upper interspace must be postulated since the spinal cord of this patient terminated at mid-L1. Our report is useful insofar as it may remind anesthesiologists and neurologists to pay attention to the unusual complications of spinal anesthesia that may require urgent intervention.
我们在此报告三例患者在硬膜外麻醉后出现的主要永久性神经并发症。磁共振成像（MR）清楚显示，第一例患者在麻醉后1天和9天出现截瘫，是由于硬膜下血肿所致；第二例是硬膜外脓肿。第三例患者突然出现左下肢麻痹，是由于在穿刺针插入过程中脊髓可能受到创伤，导致沿圆锥-圆锥上部分出现中央旁缺血性病变。尽管据报告穿刺是在L1-L2间隙进行的，但由于该患者的脊髓在L1中部终止，因此推测可能错误地进入了上一间隙。我们的报告很有用，因为它可能提醒麻醉医生和神经科医生注意脊髓麻醉可能需要紧急干预的异常并发症。
