What’s a nice patient like you doing with a complication like this? Diagnosis, prognosis and prevention of spinal hematoma

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

“…Neuraxial haematoma (in the epidural, spinal, or subdural spaces) is rare (<1:150,000 epidurals, <1:220,000 spinals) [432]. However, the potential to cause permanent neurological dysfunction promotes concern in women either with low platelet counts or taking medication affecting coagulation [433].…”

“…However, the potential to cause permanent neurological dysfunction promotes concern in women either with low platelet counts or taking medication affecting coagulation [433]. These women should be assessed soon after the block has worn off to exclude back pain or new/progressive neurological complications [432]. s Thrombocytopoenia Neuraxial haematomas have not been reported with platelet counts above 75 Â 10 9 /L, in the absence of platelet dysfunction or associated coagulopathy [434].…”

Atypical presentation of an epidural hematoma in a patient receiving aspirin and low molecular weight heparin. Was epidural analgesia the right choice?

“…It was only after the return of neurological symptoms 4 days later that she required surgical decompression. Other cases of successful conservative management of epidural hematomas have been reported [6][7][8][9][10][11][12]. Although expectant management may be reasonable in some cases, frequent neurological assessment is mandatory, as our case has demonstrated.…”

Recent Advances in Epidural Analgesia

“…Epidural hematoma is a rare, but potentially devastating, complication that requires emergency decompression in case of clinical deterioration. It is rarely attributed to an arterial source, and can develop spontaneously [94, 95]. While paralysis may occur even after hematoma evacuation, it is still not precisely understood why several of the spinal epidural hematomas associated with concurrent anticoagulant use involving less blood than the volume injected when performing a therapeutic blood patch [85].…”