Hemorrhagic Infarction of Cerebellum and Brainstem Due to Cervical Epidural Steroid Injection – Case Report and Review of the Literature

Abstract

Radiculopathy is a painful condition usually due to a compressed nerve in the spine. It is reported that cervical radiculopathy has an annual incidence of 83.2 cases per 100 000 people. Cervical epidural steroid injection is one of the main treatments, but it can result in serious adverse events, including loss of vision, stroke, paralysis, and death. A 69-year-old female died after receiving the second of three planned C5/C6 epidural steroid injections. The autopsy revealed extensive hemorrhage and necrosis of the entire right side of the cerebellum and nearby brainstem, and extensive petechial hemorrhage of the left side of the cerebellum. This report discusses the importance of a complete autopsy in the case of death due to cervical epidural steroid injection and reporting the case either to peer review literature or to the Food and Drug Administration Adverse Event Reporting System (F AERS) database.