A case of acute spinal intradural hematoma due to spinal anesthesia

Publication date: Available online 29 July 2015 Source:Journal of Acute Disease Author(s): Josué M. Avecillas-Chasín, Jordi A. Matias-Guiu, Gustavo Gomez, Javier Saceda-Gutierrez Spinal intradural hematoma is a rare complication of diagnostic lumbar puncture or spinal anesthesia. This complication could be overlooked with devastating neurological consequences due to a delay in diagnosis. Here, we reported a case of a patient with a lumbar spinal intradural hematoma as a result of a difficult spinal anesthesia.
Source: Journal of Acute Disease - Category: Emergency Medicine Source Type: research

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AbstractPurpose of ReviewPost dural puncture headache (PDPH) is a relatively common complication which may occur in the setting of inadvertent dural puncture (DP) during labor epidural analgesia and during intentional DP during spinal anesthetic placement or diagnostic lumbar puncture. Few publications have established the long-term safety of an epidural blood patch (EBP) for the treatment of a PDPH.Recent FindingsThe aim of this pilot study was to examine the association of chronic low back pain (LBP) in patients who experienced a PDPH following labor analgesia and were treated with an EBP. A total of 146 patients were co...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
Diplopia secondary to a VI nerve palsy is a rare and little-known complication after intentional or unintentional dural-arachnoid puncture, for example lumbar puncture and epidural anaesthesia.1,2 The treatment is an epidural blood patch (EBP), which is thought to normalise the traction on the nerve that has resulted from loss of cerebrospinal fluid. However, some reports describe no improvement in symptoms when the EBP was not performed in the first 24 h after the onset of diplopia.3,4
Source: International Journal of Obstetric Anesthesia - Category: Anesthesiology Authors: Tags: Correspondence Source Type: research
Passing a spinal needle through a tattoo is not known to result in adverse effects. However, skin cells can be carried into the spinal canal during lumbar puncture, rarely resulting in an intraspinal epidermoid cyst, and therefore, it is possible to introduce tattoo pigment into the spinal canal. The obstetrics anesthesia literature discusses targeting of a spared patch of skin within the tattoo or creation of a small stab wound through which the needle is then introduced.1 A new alternative is to pass the spinal needle through a short, larger needle (figure).
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: Case Source Type: research
(Reg Anesth Pain Med. 2019;44(1):29–31) Lumbar puncture (LP) is commonly performed for diagnostic and therapeutic purposes in patients with leukemia and lymphoma, who often develop thrombocytopenia. Oncologists are typically cautious to expose patients to unnecessary blood products for fear of alloimmunization, and therefore will perform LP at thrombocytopenic levels beyond that which anesthesiologists would deem acceptable for neuraxial procedures. There may be lessons anesthesiologists can learn from oncologists regarding spinal anesthesia in thrombocytopenic patients and the lowest platelet count at which regiona...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Editorials and Reviews Source Type: research
A 17-year-old boy developed postdural puncture headache after several lumbar punctures (LPs) for intrathecal chemotherapy. The pediatric anesthesiology service was consulted for an epidural blood patch (EBP). Sedation was required for the LPs, which made performing an EBP problematic because of the need for the patient to be conscious and able to report symptoms during injection of blood. An epidural catheter was placed after the next LP while the patient was sedated. After he woke up, blood was injected through the catheter and the headache resolved. This technique can be used in pediatric patients requiring deep sedation for an EBP.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
Abstract Nitrous oxide (N2 O) is frequently used for short anaesthesia/analgesia in children undergoing painful or repetitive procedures1 . Children with acute lymphoblastic leukaemia (ALL) require repeated lumbar punctures with direct instillation of intrathecal chemotherapy, usually the anti-folate agent Methotrexate, during their treatment. These procedures are frequently performed under anaesthesia. Concerns have been intermittently raised about a drug-interaction between methotrexate and N2 O that may potentiate the undesirable side effects of methotrexate, including neurotoxicity. However, the clinical evide...
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
SPROTTE Lumbar with Introducer, labeled as the following: 1. Sprotte 22G x 90mm w/ introducer and wings (25/box); 2. Sprotte 22G x 120mm w/ introducer and wings (25/box); 3. Sprotte 19G x 90mm w/ introducer and wings (25/box]); 4. Sprotte 22G x 103mm w/ introducer and wings (25/box); 5. Sprotte 21G x 90mm w/ introducer and wings (25/box); 6. Sprotte 21G x 103mm w/ introducer and wings (25/box); 7. Sprotte 20G x 103mm w/ introducer and wings (25/box); 8. Sprotte 20G x 90mm w/ introducer and wings (25/box) Product Usage: The SPROTTE¿ lumbar puncture needles are intended to gain entry into or puncture the spina...
Source: Medical Device Recalls - Category: Medical Devices Source Type: alerts
Lenggenhager Cordey Kaiser : Meningitis, encephalitis, and myelitis are various forms of acute central nervous system (CNS) inflammation, which can coexist and lead to serious sequelae. Known aetiologies include infections and immune-mediated processes. Despite advances in clinical microbiology over the past decades, the cause of acute CNS inflammation remains unknown in approximately 50% of cases. High-throughput sequencing was performed to search for viral sequences in cerebrospinal fluid (CSF) samples collected from 26 patients considered to have acute CNS inflammation of unknown origin, and 10 patients wit...
Source: Genes - Category: Genetics & Stem Cells Authors: Tags: Article Source Type: research
ConclusionsIH is an under-recognized cause of seizure following the spinal or cranial surgery, lumbar puncture, or spinal anesthesia. Proposed mechanisms include traction on cortical structures, increased cerebral blood flow, and cortical irritation secondary to subdural hygromas.
Source: Neurocritical Care - Category: Neurology Source Type: research
Conclusions: Physicians handedness bias and patient laterality of recumbent position affects the success of LPs. Right-handed physicians have a greater chance of performing successful LPs when patients are in the left LRP, and vice versa.
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Clinical Investigations Source Type: research
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