Hématome péridural rachidien spontané au cours de la grossesse

Consolo, Douglas Altamiro; Vadala, A.-A.; Rollin, P.E.; Merle, Bénédicte M. J.; Girard, Chloé

doi:10.1016/j.annfar.2007.01.019

Cited by 9 publications

(5 citation statements)

References 18 publications

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“…The prone position for the spine operation as well as the general anesthesia required have associated risks for the fetus; however, if the pregnancy is sustained, the risk for respiratory distress syndrome and other respiratory morbidity can be reduced. 26 In the studies reviewed, all of the women experienced neurologic deficits and were managed operatively 5 6 7 8 9 10 11 12 13 14 15 16 ; therefore, this is the first case of spontaneous resolution. We chose nonoperative management with close observation for this patient because she had no neurologic deficit, only pain.…”

Section: Discussionmentioning

confidence: 98%

“… 26 There have been a small number of reports of pregnant women with an SSEH. 5 6 7 8 9 10 11 12 13 14 15 16 Three cases before 31 weeks' gestation were carried through term, but almost all infants born after 32 weeks were delivered by cesarean section. From 32 to 36 weeks, it is very difficult to decide if the best course of action is to deliver the baby or to continue the pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“… 1 There have been many reports of SSEH, 2 3 4 but few during pregnancy. 5 6 7 8 9 10 11 12 13 14 15 16 In general, recurrent SSEHs are uncommon. 17 18 19 20 We report a case of SSEH recurrence during pregnancy and its spontaneous resolution.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneously Resolved Recurrent Cervical Epidural Hematoma in a 37-Week Primigravida

Iwatsuki

Deguchi

Hirata

et al. 2015

Global Spine Journal

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Study Design Case report. Objective To describe a patient with a recurrent spontaneous spinal epidural hematoma (SSEH) during pregnancy that had spontaneous remission. Methods A 27-year-old primigravida at 37 weeks' gestation suddenly felt a strong left shoulder pain without any trauma. She had a history of fenestration for a spontaneous cervical hematoma when she was 18 years old. An emergency magnetic resonance imaging revealed a recurrence of the cervical epidural hematoma at the C4–T1 level, but she had no paralysis. Results The patient subsequently underwent a cesarean section and delivered a healthy male infant. Her spinal epidural hematoma disappeared. Multislice computed tomography showed no evidence for a vascular malformation or tumor. Three years after the initial cesarean section, she underwent a second one and delivered another male infant. Conclusions We report on a rare case of recurrent SSEH during pregnancy with no neurologic deficits that was treated nonoperatively with close observation and resulted in spontaneous resolution. In such patients with no neurologic deficits, nonoperative management with close observation may be a reasonable alternative.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneously Resolved Recurrent Cervical Epidural Hematoma in a 37-Week Primigravida

Iwatsuki

Deguchi

Hirata

et al. 2015

Global Spine Journal

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“…It also facilitates SSEH diagnosis and thus allows the detection of more cases with an onset, exact, and natural change course. Other secondary causes, such as increased bleeding tendency for various medications ( 11 ), blood dyscracia ( 12 ), hypertension ( 13 ), indirect spinal trauma ( 14 ), and pregnancy ( 15 ), were also discussed in literature.…”

Section: Discussionmentioning

confidence: 99%

Acute Cervical and Thoracic Ventral Side Spontaneous Spinal Epidural Hematoma Causing High Paraplegia: A Case Report

Zhao¹,

Shu²,

Cai³

et al. 2017

Anesth Pain Med

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IntroductionSpontaneous spinal epidural hematoma (SSEH) is a rare condition that can potentially cause paraplegia. SSEH has an increasing incidence rate and its cause remains unclear. Magnetic resonance imaging (MRI) results shows that SSEH presents a spinal epidural space-occupying lesion; therefore, emergency surgical treatment is required in some cases. MRI results of most SSEH cases showed that hematoma occurs in the dorsal or lateral side. By contrast, hematoma in the ventral side is very rarely shown.Case PresentationA 42-year-old healthy woman developed a sudden onset of severe neck pain with mild limb weakness, gradual breathing difficulty, and high paraplegia. MRI results revealed that an SSEH was compressing her spinal cord in the ventral epidural space from C2 to T3. Upon admission, she received emergency decompressive laminectomy in a posterior approach from C3 to T1, and the epidural hematoma was evacuated through full incision of the dorsal side dural, release of cerebrospinal fluid, and intermittent incision of the ventral side dural. The symptoms of limb paralysis and breathing distress gradually improved after recover rehabilitation, and the patient was discharged with life self-care after 2 months.ConclusionsPerforming early decompressive laminectomy and evacuation of hematoma on severe SSEH patients improves neurological outcomes. For patients with ventral side SSEH, the cerebrospinal fluid should be released after the incision on the dorsal side dural, and the ventral side dural should be gradually as well as intermittently clipped to evacuate the hematoma. The patient would also receive a good prognosis after the total release of the spinal cord compression.

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“…The spontaneous epidural haematoma is a very rare situation in obstetrical patients: only some cases occured during pregnancy are reported each year in the literature [1][2][3]. It's spontaneous when there is no traumatism, no arteriovenous malformation, no blood disorders, and no lumbar nor epidural puncture [1,4].…”

Section: Introductionmentioning

confidence: 99%