RESUMO
El hematoma epidural espinal secundario a anestesia neuroaxial es una complicación grave, aunque poco frecuente. La mayoría de los casos se asocia a tratamiento anticoagulante o circunstancias que favorezcan el sangrado. Por las graves secuelas secundarias a la compresión medular se considera una urgencia quirúrgica, siendo crucial en su pronóstico la precocidad en la descompresión medular. Presentamos un caso de hematoma epidural espinal dorsolumbar asociado a anestesia intradural y analgesia epidural en una paciente con tromboprofilaxis con heparina de bajo peso molecular, con recuperación espontánea con tratamiento conservador(AU)
Spinal epidural haematoma after neuroaxial anaesthesia is a rare but serious complication. Most cases are attributed to anticoagulant therapy or bleeding tendency. It presents as an acute spinal cord compression and usually requires emergency surgical decompression. The interval between the onset of clinical signs and surgical evacuation is very important, influencing the neurological prognosis. We report a case of a spinal epidural haematoma after epidural analgesia in a patient who was treated with low molecular weight heparin for thrombo-prophylaxis in the perioperative period. In some cases, such as the one reported here, good neurological recovery can be achieved with conservative management(AU)
Assuntos
Humanos , Masculino , Feminino , Paraparesia/induzido quimicamente , Anestesia Epidural/efeitos adversos , Anestesia Epidural/métodos , Anestesia Epidural , Analgesia Epidural , Hematoma Epidural Espinal/induzido quimicamente , Hematoma Epidural Espinal/complicações , Compressão da Medula Espinal/induzido quimicamente , Compressão da Medula Espinal/complicações , Heparina de Baixo Peso Molecular/uso terapêutico , Compressão da Medula Espinal , Paraparesia/complicações , Analgesia Epidural/métodos , Analgesia Epidural/tendênciasRESUMO
Spinal epidural haematoma after neuroaxial anaesthesia is a rare but serious complication. Most cases are attributed to anticoagulant therapy or bleeding tendency. It presents as an acute spinal cord compression and usually requires emergency surgical decompression. The interval between the onset of clinical signs and surgical evacuation is very important, influencing the neurological prognosis. We report a case of a spinal epidural haematoma after epidural analgesia in a patient who was treated with low molecular weight heparin for thrombo-prophylaxis in the perioperative period. In some cases, such as the one reported here, good neurological recovery can be achieved with conservative management.
