Spinal epidural hematoma in a patient with lupus coagulopathy: MR findings.

Mohazab, H R; Länger, B; Spigos, D G

doi:10.2214/ajr.160.4.8456680

Cited by 16 publications

(5 citation statements)

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“…Anatomic abnormalities, traumatic puncture with multiple attempts, and coagulation disorders or anticoagulation therapy are also risk factors for spinal epidural hematoma development 5 . Spontaneous epidural hematomas have been reported in those with liver and autoimmune disease 13,17 . They have also been associated with thrombolytic therapy and anticoagulants 1,9,12 .…”

Section: Discussionmentioning

confidence: 99%

Lumbar epidural hematoma following lumbar puncture: the role of high dose LMWH and late surgery. A case report

Gürkanlar¹,

Açikbas

Cengiz

et al. 2007

Neurocirugía

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SummarySpinal epidural hematoma (SEH) is a known complication of spinal surgery, but the incidence of post-surgical SEHs that result in neurologic deficits is extremely rare (0.1%). Patients that require multilevel lumbar procedures and/or have a preoperative coagulopathy are at a significantly higher risk of developing an epidural hematoma. The introduction of higher dose of low molecular weight heparin (LMWH) twice daily 30 mg regimen) increased the reported incidence of neuroaxial hematomas. Surgery performed within 8 hours makes good or partial recovery of neurologic function.Our patient was also started on higher dose of LMWH and developed neurological deficits due to a SEH following lumbar puncture. She underwent operation after six days and she had a mild recovery following the operation.Current administration of high doses of LMWH can cause SEH even after a lumbar puncture, which was performed without multiple attempts.Although surgery performed within 8 hours makes good or partial recovery of neurologic function, laminectomy and epidural hematoma evacuation performed after three days can also have successful results.KEY WORDS: Lumbar. Epidural hematoma. Surgery. LMWH. Myelography. Hematoma lumbar epidural postpunción lumbar; influencia de dosis altas de LMWH y cirugía diferida ResumenEl hematoma espinal epidural (HEE) es una complicación conocida en la cirugía espinal, pero la incidencia del HEE que da lugar a déficit neurológico es muy rara (0,1%). Los pacientes que necesitan intervenciones en varios niveles lumbares y/o que tienen una coagulopatía preoperatoria tienen un riesgo significativamente mayor de desarrollar un hematoma epidural. La introducción de dosis altas de heparina de bajo peso molecular (HBPM), (30 mgrs. dos veces al día) aumentan la incidencia de hematomas neuroaxiales. La cirugía llevada a cabo dentro de las 8 horas da lugar a un recuperación buena o parcial de la función neurológica.Nuestro paciente fue tratada con dosis altas de HBPM y desarrolló un déficit neurológico debido a un HEE, después de una punción lumbar. Fue operada al cabo de seis días y se recuperó parcialmente de su déficit después de la intervención. La administración actual de dosis altas de HBPM puede dar lugar a HEE, incluso después de una punción lumbar, que se hizo en pocos intentos.Aunque la cirugía realizada en las primeras 8 horas produce una recuperación buena o parcial, la laminectomía y evacuación del hematoma llevada a cabo después de tres días también puede dar lugar a buenos resultados.

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Section: Discussionmentioning

confidence: 99%

Lumbar epidural hematoma following lumbar puncture: the role of high dose LMWH and late surgery. A case report

Gürkanlar¹,

Açikbas

Cengiz

et al. 2007

Neurocirugía

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“…The thin subarachnoidal space which contained a hematoma is also visible (0). The patient suffering from lupus, who had been operated on, had a worse outcome, probably due to the longstanding deleterious effects of the disease rather than due to the hematoma (20). The most important differential diagnosis is disc herniation.…”

Section: Discussionmentioning

confidence: 99%

Nontraumatic spinal epidural hematomas

et al. 1997

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“…The association between SSEH and SLE is an extremely rare but known association [2]. To our knowledge, it has been reported previously in three cases in the literature [3–5]. Mohazab was the first to report a radiological coexistence of spinal epidural haematoma in a patient with lupus [3].…”

mentioning

confidence: 86%

“…To our knowledge, it has been reported previously in three cases in the literature [3–5]. Mohazab was the first to report a radiological coexistence of spinal epidural haematoma in a patient with lupus [3]. Goker described a 44‐year‐old woman with SLE and SSEH.…”

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confidence: 89%