6,336 results match your criteria Epidural Hematoma


A forehead hematoma as the initial clinical sign of lung cancer.

Arch Craniofac Surg 2020 Jun 29;21(3):198-201. Epub 2020 Jun 29.

Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.

Primary lung cancer commonly metastasizes to the brain, bones, liver, and adrenal glands. In some cases, bone metastasis serves as the first presenting sign of lung cancer with bone pain and headache, but it is not common. The incidence of skull metastasis in lung squamous cell carcinoma (SCC) is low, and there have been only a few cases of skull metastases serving as the first sign of malignancy with skull mass and epidural bleeding; however, no similar cases have been reported regarding that of hematoma. Read More

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http://dx.doi.org/10.7181/acfs.2020.00129DOI Listing

Patient satisfaction with continuous epidural analgesia after major surgical procedures at a Swedish University hospital.

PLoS One 2020 2;15(7):e0235636. Epub 2020 Jul 2.

Department of Surgical Sciences, Unit for Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.

Objective: The use of epidural analgesia after major surgery is a well-established analgesia method. Epidural analgesia for postoperative pain relief needs to be monitored regularly in order to evaluate patient satisfaction and avoid side effects. However, due to the new available regional techniques, the role of epidural analgesia is being questioned and data about patient satisfaction is lacking. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235636PLOS

Neuraxial and Perineural Bleeding after Neuraxial Techniques: An Overview of the Last Year.

Eurasian J Med 2020 Jun 9;52(2):211-216. Epub 2020 Jun 9.

Department of Medicine - DIMED, University of Padova Section of Anesthesiology and Intensive Care, Padova, Italy.

Spinal hematoma following neuraxial or perineural techniques is a rare but severe complication that can potentially lead to catastrophic consequences. The aim of this review is to analyze all reported cases of neuraxial or perineural bleeding after performance of a locoregional technique since the last guidelines update in 2018. We included articles indexed by MEDLINE, Scopus, and Google Scholar. Read More

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http://dx.doi.org/10.5152/eurasianjmed.2019.19212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311137PMC

Non traumatic spinal epidural haematoma.

Authors:
N A Khalid N Shah

Acute Med 2019 ;18(1):38-40

MBBS, MD, MRCP, FRCP, Consultant Physician and Geriatrician, University hospitals of Leicester NHS trust, Leicester Royal Infirmary.

Spinal epidural haematoma is a rare condition, which may be due to trauma, surgery, epidural catheterisation or disorders of coagulation. We report a case of 60 year old lady who was on warfarin for Atrial fibrillation (AF) presented with history of non-traumatic sudden onset pain in both legs and difficulty in walking. Magnetic resonance imaging (MRI) spine demonstrated epidural haematoma which was treated conservatively. Read More

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January 2019

Traumatic Retroclival Epidural Hematoma.

Pediatr Emerg Care 2019 Feb 19. Epub 2019 Feb 19.

Neurosurgery Clinic, Okmeydani Training and Research Hospital, Istanbul, Turkey.

Retroclival epidural hematomas are particularly rare conditions that are frequently the result of high-energy, hyperflexion-hyperextension injuries in pediatric patients. We present the case of a 7-year-old previously healthy girl with traumatic retroclival epidural hematoma after a fall from a swing. She presented with a Glasgow Coma Scale score of 15 with severe neck pain and limitation of cervical movements in all directions. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001756DOI Listing
February 2019

Middle meningeal artery embolization to treat progressive epidural hematoma: a case report.

J Cerebrovasc Endovasc Neurosurg 2020 Mar 31;22(1):20-25. Epub 2020 Mar 31.

Department of Neurosurgery, Cheju Halla General Hospital, Jeju, Korea.

Progressive epidural hematoma is a form of acute epidural hematoma that gradually expands from a small initial hematoma; in cases that are clinically aggravated due to the presence of a mental illness or neurological condition, patients should be surgically treated for evacuation of the hematoma, but poorer outcomes are expected if the patient has several medical co-morbidities for surgery. We experienced two cases of progressive epidural hematoma which were successfully managed by endovascular treatment: an 85-year-old male with medical co-morbidities and a 51-year-old female with a poor-grade subarachnoid hemorrhage resulting from the rupture of a dissecting aneurysm of the vertebral artery. In both cases, a middle meningeal artery embolization was performed and contrast leakage was observed and controlled using cerebral angiography, halting the progression of their epidural hematomas. Read More

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http://dx.doi.org/10.7461/jcen.2020.22.1.20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307609PMC

Acute spinal epidural hematoma: A case report and review of the literature.

Ulus Travma Acil Cerrahi Derg 2020 Jun;26(4):628-631

Department of Neurosurgery, Okan University Faculty of Medicine, İstanbul-Turkey.

Spinal epidural hematoma (SEH) is a rare but a significant cause of spinal cord compression and neurologic deficits. Its etiology is usually unknown and requires emergency intervention. The present study aims to review the clinical significance, treatment strategies and clinical outcomes of traumatic SEH with a rare case presentation. Read More

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http://dx.doi.org/10.14744/tjtes.2019.60956DOI Listing

Spontaneous Intracranial Hypotension with a Reversible Splenial Lesion after Swimming.

Intern Med 2020 Jun 23. Epub 2020 Jun 23.

Department of Neurology, Tokyo Teishin Hospital, Japan.

Spontaneous intracranial hypotension (SIH) is an important cause of headache mainly associated with spinal cerebrospinal fluid leakage. We herein report the case of a 51-year-old man who developed SIH after swimming. Brain magnetic resonance imaging (MRI) showed a transient high-intensity lesion in the splenium of the corpus callosum (SCC), in addition to bilateral subdural hematomas (SDH) and pseudo-subarachnoid hemorrhage on brain computed tomography. Read More

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http://dx.doi.org/10.2169/internalmedicine.4971-20DOI Listing

Spontaneous spinal epidural haematoma due to polypharmacy including multiple antiplatelet agents.

Postgrad Med J 2020 Jun 23. Epub 2020 Jun 23.

General Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan.

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http://dx.doi.org/10.1136/postgradmedj-2020-137755DOI Listing

Outcomes and Clinical Characteristics of Intracranial Hemorrhage in Patients with Hematological Malignancies: A Systematic Literature Review.

World Neurosurg 2020 Jun 18. Epub 2020 Jun 18.

Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland Ohio.

Background: Many clinical and demographic factors can influence survival of patients with hematological malignancies who have intracranial hemorrhages. Understanding the influence of these factors on patient survival can guide treatment decisions and may inform prognostic discussions. We conducted a systematic literature review to determine survival of patients with intracranial hemorrhages and concomitant hematologic malignancy. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.091DOI Listing

Traumatic epidural hematomas in the pediatric population: clinical characteristics and diagnostic pitfalls.

J Pediatr Surg 2020 May 15. Epub 2020 May 15.

Division of Trauma, Emergency Surgery and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, 2051 Marengo Street, IPT, C5L100, Los Angeles, CA 90033, USA.

Background/purpose: The purpose of this study was to review the initial clinical presentation of EDH, identify potential clinical markers and highlight diagnostic pitfalls.

Methods: Retrospective review of all pediatric patients admitted to a Level I Trauma Center diagnosed with blunt traumatic EDH from 2008 to 2018.

Results: A total of 699 pediatric patients were identified with blunt traumatic brain injury (TBI); 106 with EDH made up the study population. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2020.05.011DOI Listing

Fungal mycotic aneurysm in a patient with chronic meningoencephalitis.

Surg Neurol Int 2020 6;11:139. Epub 2020 Jun 6.

Departments of Neuroinfectology, National Institute of Neurology and Neurosurgery, Mexico.

Background: Central nervous system involvement due to aspergillosis is an extremely serious entity, particularly in patients with severe neutropenia, hematological diseases, or post-transplant cases. Immunocompetent patients can be infected by intense exposure, particularly iatrogenic after invasive procedures.

Case Description: We present the case of a 26-year-old male with a 1 year appendectomy background, which required epidural anesthesia. Read More

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http://dx.doi.org/10.25259/SNI_506_2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294177PMC

High fibrin/fibrinogen degradation product value as a risk factor for progressive remote traumatic intracranial haemorrhage following neurosurgery.

Br J Neurosurg 2020 Jun 12:1-4. Epub 2020 Jun 12.

Department of Neurosurgery, University of Tsukuba, Tsukuba, Japan.

Remote traumatic intracranial haemorrhage (RTIH) may develop after neurosurgery. Recognition of the risk factors for RTIH before surgery might be of great value. The purpose of this study was to verify if the fibrin/fibrinogen degradation product (FDP) value may be a risk factor for RTIH. Read More

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http://dx.doi.org/10.1080/02688697.2020.1775788DOI Listing

Acute deterioration in a patient with bilateral chronic subdural hematomas associated with intracranial hypotension treated with an epidural blood patch: A case report.

World Neurosurg 2020 Jun 6. Epub 2020 Jun 6.

Department of Neurosurgery, Kochi Medical School, Kochi University, Kochi, Japan.

Background: Intracranial hypotension due to cerebrospinal fluid (CSF) leak is often associated with secondary chronic subdural hematoma (CSDH). Although epidural blood patch (EBP) treatment for the CSF leak site has been reported to result in spontaneous regression of the CSDH in most cases, it is still debatable whether blocking CSF leak first in the patients with intracranial hematoma is always safe.

Case Description: A 72-year-old woman presented with orthostatic headache after a head injury and was diagnosed with intracranial hypotension. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.05.254DOI Listing

[Lower extremity paralysis caused by epidural hematoma after sacral canal block technique in patient with oral warfarin:a case report].

Zhongguo Gu Shang 2019 10;32(10):960-964

Department of Orthopaedics and Traumatology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China;

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http://dx.doi.org/10.3969/j.issn.1003-0034.2019.10.018DOI Listing
October 2019

Technical note: Novel use of recombinant tissue plasminogen activator for the evacuation of an acute extensive spinal epidural haematoma in a patient with coagulopathy.

Br J Neurosurg 2020 May 28:1-4. Epub 2020 May 28.

National Centre of Neurosurgery, Beaumont Hospital, Dublin, Ireland.

Spontaneous extensive spinal epidural haematoma poses a unique challenge for the neurosurgeon. Performing extensive laminectomies to remove all of the compressive haematoma can destabilise the patient's spinal column, which may require fixation. This is further complicated in patients with significant coagulopathy. Read More

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http://dx.doi.org/10.1080/02688697.2020.1773395DOI Listing

Incidence and risk factors of spinal epidural hemorrhage after spine surgery: a cross-sectional retrospective analysis of a national database.

BMC Musculoskelet Disord 2020 May 25;21(1):324. Epub 2020 May 25.

College of Pharmacy, Korea University, 2511 Sejong-ro, Sejong-si, 30019, South Korea.

Background: With increasing number of patients undergoing spine surgery, the spinal epidural hemorrhage (SEH) has become a growing concern. However, current studies on SEH rely on case reports or observations from a single center. Our study attempted to demonstrate the incidence rate and risk factors of SEH using a national dataset. Read More

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http://dx.doi.org/10.1186/s12891-020-03337-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249427PMC

Emergency Burr Hole utilizing the EZ-IO™ drill: A pilot cadaver study.

Am J Emerg Med 2020 May 8. Epub 2020 May 8.

Charleston Area Medical Center Health Education and Research Institute, 3200 MacCorkle Ave. SE, Charleston, WV 25304, USA.

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http://dx.doi.org/10.1016/j.ajem.2020.05.008DOI Listing

Reconstruction of Complex Cranial and Orbit Fractures with Associated Hemorrhages: Case Report and Review of the Literature.

Cureus 2020 Apr 16;12(4):e7694. Epub 2020 Apr 16.

Neurological Surgery, The University of Toledo Medical Center, Toledo, USA.

We present our experience following a unique case of coincident intracranial hemorrhage and comminuted fractures of both the squamous temporal bone and zygomaticofrontal orbit. Surgical techniques and outcome for this presentation have yet to be sufficiently described. A 55-year-old male presented following trauma with Glasgow Coma Scale score of 7. Read More

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http://dx.doi.org/10.7759/cureus.7694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233501PMC

Intracranial emergencies during pregnancy requiring urgent neurosurgical treatment.

Clin Neurol Neurosurg 2020 May 12;195:105905. Epub 2020 May 12.

Department of Neurosurgery, Hannover Medical School, Hannover, Germany.

Objective: Despite contemporary diagnostic and therapeutic techniques intracranial emergencies in the obstetric setting pose still a major challenge for the clinicians. There are limited guidelines and differing ethical views. Multidisciplinary teams are needed to support the pregnant woman in a way that she can deliver a viable and healthy child. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105905DOI Listing

Tracheal Irrigation Without Bronchoscopy as an Alternative Emergent Treatment of Blood Aspiration.

J Emerg Med 2020 May 13;58(5):e223-e226. Epub 2020 May 13.

Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.

Background: Tracheobronchial foreign body aspiration can cause mild symptoms but may also become dangerous enough to cause death. Bronchoscopy is the first choice for the diagnosis and the removal of aspirated foreign bodies. So, when bronchoscopy is not available, the situation might get challenging. Read More

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http://dx.doi.org/10.1016/j.jemermed.2020.04.011DOI Listing

Incidence and Clinical Features of Postoperative Symptomatic Hematoma after Spine Surgery: A Multicenter Study of 45 Patients.

Spine Surg Relat Res 2020 1;4(2):130-134. Epub 2019 Nov 1.

Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.

Introduction: Symptomatic postoperative hematoma after spine surgery is a rare but serious complication. The objective of this study was to investigate the incidence and clinical features of symptomatic postoperative hematoma after spine surgery.

Methods: We retrospectively identified 10,680 patients who underwent spine surgery between 2002 and 2012 in nine hospitals. Read More

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http://dx.doi.org/10.22603/ssrr.2019-0080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217683PMC
November 2019

Utility of heavily T2-weighted MR myelography as the first step in CSF leak detection and the planning of epidural blood patches.

J Clin Neurosci 2020 Jul 8;77:110-115. Epub 2020 May 8.

Department of Radiology, Seoul National University Bundang Hospital, Republic of Korea.

Heavily T2-weighted MR myelography (HT2W-MRM) is emerging as an alternative approach for detection and follow up of CSF leaks. We aimed to assess epidural blood patch (EBP) treatment outcome when using HT2W-MRM as the primary modality for detecting CSF leak and planning EBP placement in routine clinical practice. Since 2018, patients at our institute suspected of having CSF leak, routinely HT2W-MRM instead of CT myelography to determine presence of the leak and identify the EBP target site. Read More

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http://dx.doi.org/10.1016/j.jocn.2020.05.010DOI Listing

[Atypical presentation of spontaneous spinal epidural haematoma].

Ugeskr Laeger 2020 May;182(20)

Spontaneous spinal epidural haematoma is a rare condition with serious long- term effects. It has no proven causes but is associated with use of blood thinners, coagulopathies, underlying vascular malformations or tumours, and pregnancy. This is a case report of a 57-year-old woman with an atypical presentation, where an intracranial condition was suspected. Read More

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A Case of Traumatic Pneumocephalus on the Opposite Side of the Injury Site.

Authors:
Ki Seong Eom

Korean J Neurotrauma 2020 Apr 20;16(1):73-78. Epub 2020 Apr 20.

Department of Neurosurgery, Wonkwang University College of Medicine, Iksan, Korea.

Pneumocephalus is defined as an abnormal presence of intracranial air or gas. Traumatic pneumocephalus (TP) typically occurs on the injured side and is in communication with the external environment. This report presented an extremely rare case of TP that occurred on the opposite side of the injured site, even with the absence of any traumatic injury. Read More

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http://dx.doi.org/10.13004/kjnt.2020.16.e9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192804PMC

Traumatic acute convexity interdural hematoma: a case report and literature review.

Br J Neurosurg 2020 May 2:1-3. Epub 2020 May 2.

Neurosurgery Department, Tehran University of Medical Sciences, Tehran, Iran.

Interdural hematoma (IDH) is an extremely rare hemorrhage between the outer periosteal dura mater and the inner meningeal dura mater. There are 8 cases of convexity IDH reported previously but none of them were acute post traumatic one. We report the case of a patient with an initial diagnosis of acute epidural hematoma (EDH) that was eventually revealed to be an acute convexity IDH. Read More

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http://dx.doi.org/10.1080/02688697.2020.1749985DOI Listing

Antiplatelet and Anticoagulant Risk for Select Spine Interventions: A Retrospective Cohort.

Pain Med 2020 05;21(5):910-917

Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee.

Objectives: To identify significant bleeding complications following spinal interventions in patients taking medications with antiplatelet or anticoagulation effect.

Design: Retrospective chart review of a 12-month period.

Setting: Outpatient academic medical practice. Read More

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http://dx.doi.org/10.1093/pm/pnaa009DOI Listing

The incidence of symptomatic postoperative epidural hematoma after minimally invasive lumbar decompression: A single institution retrospective review.

Clin Neurol Neurosurg 2020 Apr 22;195:105868. Epub 2020 Apr 22.

Medstar Georgetown University Hospital, Department of Neurosurgery, Washington, DC, United States. Electronic address:

Objective: Postoperative epidural hematoma (PEDH) after minimally invasive lumbar laminectomy (MILL) can lead to significant morbidity and healthcare cost. The incidence is not well characterized in the literature as compared with traditional open techniques. Our aim was to define the incidence of PEDH after MIS lumbar decompression procedures and evaluate strategies for reduction of PEDH. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105868DOI Listing

The Practice of Continuation of Anti-platelet Therapy During the Perioperative Period in Lumbar Minimally Invasive Spine Surgery (MISS): How Different Is the Morbidity in This Scenario?

Spine (Phila Pa 1976) 2020 May;45(10):673-678

Mumbai Spine Scoliosis and Disc Replacement Centre, Bombay Hospital and Medical Research Center, Mumbai, India.

Study Design: Cohort.

Objective: To evaluate perioperative morbidity in patients undergoing minimally invasive spine surgery of the lumbar spine while continuing the antiplatelet drug (APD) perioperatively as compared with those not continuing these drugs and those not on these drugs.

Summary Of Background Data: While discontinuation of antiplatelet drugs carries with it the risk of thrombosis of the cardiac stents, myocardial infarction, peripheral vascular occlusion, cerebro-vascular events and other thrombotic complications, continuation of these drugs has the risk of intra spinal bleeding and the serious consequences of subsequent epidural hematoma with associated spinal cord compression. Read More

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http://dx.doi.org/10.1097/BRS.0000000000003357DOI Listing

Spinal Epidural Hematoma After Attempted Catheter Thrombectomy of a Large Iliofemoral Deep Venous Thrombosis: A Case Report.

R I Med J (2013) 2020 May 1;103(4):52-54. Epub 2020 May 1.

Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence.

The authors report the case of an 82-year-old woman with a spinal epidural hematoma following attempted catheter-directed thrombolysis of a large femoral- popliteal deep venous thrombosis. The patient rapidly developed acute motor and sensory paralysis below the level of T7 within hours of the thrombectomy procedure. Computed tomography imaging revealed that the catheter had perforated the wall of the right inferior vena cava and magnetic resonance imaging subsequently demonstrated an extensive T1-S1 dorsal epidural hematoma with compression of the thoracic spinal cord, conus medullaris, and cauda equina. Read More

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Spontaneous Spinal Epidural Hematoma: An Atypical Clinical Presentation and Discussion of Management.

Int J Spine Surg 2020 Apr 30;14(2):158-161. Epub 2020 Apr 30.

Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia.

Introduction: Spontaneous spinal epidural hematoma (SSEH) is a rare but potentially devastating condition if not appropriately identified and managed. A few case series exist regarding SSEH and certain risk factors have been described; however, much continues to be unknown regarding the pathophysiology and optimal management.

Case Presentation: We present the case of SSEH in a healthy 33-year-old African American woman with no identifiable risk factors who initially presented with significant neurologic compromise. Read More

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http://dx.doi.org/10.14444/7030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188101PMC

Spontaneous Spinal Epidural Hematoma in a Patient on Apixaban for Nonvalvular Atrial Fibrillation.

Case Rep Hematol 2020 14;2020:7419050. Epub 2020 Apr 14.

Detroit Medical Center Sinai Grace Hospital, Detroit, MI, USA.

Background: With the rise in the use of direct oral anticoagulants (DOACs), more hemorrhagic complications are being encountered. Since the first description of a case of spontaneous spinal epidural hematoma (SSEH) related to the utilization of DOACs in 2012, there have been few reports describing a similar association. However, no cases so far have reported an association between SSEHs and apixaban. Read More

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http://dx.doi.org/10.1155/2020/7419050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178514PMC

Initial Factors Affecting 6-month Outcome of Patients Undergoing Surgery for Acute Post-traumatic Subdural and Epidural Hematoma.

Folia Med (Plovdiv) 2020 Mar;62(1):94-104

Medical University in Lublin, Lublin, Poland.

Introduction: The most frequent consequences of a traumatic brain injury are acute subdural (SDH) and epidural hematoma (EDH), which usually require a surgical treatment. Most of the factors affecting the prognosis have been analyzed on a wide group of traumatic brain injuries. Nonetheless, there are few studies analyzing factors influencing the prognosis regarding patients with EDH and SDH. Read More

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http://dx.doi.org/10.3897/folmed.62.e47743DOI Listing

Acute-on-Chronic Vertex Epidural Hematoma with Diastasis of the Sagittal Suture in an Adult.

World Neurosurg 2020 Apr 21;139:245-249. Epub 2020 Apr 21.

Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, Szczecin, Poland.

Background: Vertex epidural hematoma (VEDH) is a rare intracranial mass constituting roughly 2.5% of all epidural hematomas. Bleeding usually derives from the superior sagittal sinus, and presentation is often acute-seldom chronic. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.04.088DOI Listing

Cerebrospinal fluid leak presented with the C1-C2 sign caused by spinal canal stenosis: a case report.

BMC Neurol 2020 Apr 23;20(1):151. Epub 2020 Apr 23.

Department of Neurosurgery, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo, 136-0075, Japan.

Background: Intracranial hypotension is a disorder characterized by low cerebrospinal fluid (CSF) pressure typically caused by loss of CSF. Although some mechanisms account for the CSF leakage have been elucidated, spinal canal stenosis has never been reported as a pathological cause of intracranial hypotension. C1-C2 sign is a characteristic imaging feature, which indicates CSF collection between the spinous processes of C1 and C2, occasionally observed on magnetic resonance imaging (MRI) in patients with intracranial hypotension. Read More

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http://dx.doi.org/10.1186/s12883-020-01697-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181568PMC

Epidural hematoma due to Gardner-Wells Tongs placement during pediatric spinal deformity surgery.

Spine Deform 2020 Apr 20. Epub 2020 Apr 20.

Department of Orthopaedic Surgery, Columbia University College of Physicians and Surgeons, 5141 Broadway, New York, NY, 10034, USA.

Background: To our knowledge, this is the first documented report of an operative cranial epidural hematoma secondary to skull fracture due to placement of Gardner-Wells Tongs (GWT) in the setting of a spinal deformity reconstruction.

Purpose: The objective is to illustrate the possibility of cranial pathology secondary to GWT placement and the need to properly correlate intraoperative neuromonitoring findings.

Study Design: Case report. Read More

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http://dx.doi.org/10.1007/s43390-020-00116-2DOI Listing

The importance of skull impact site for minor mechanism head injury requiring neurosurgical intervention.

Childs Nerv Syst 2020 Apr 17. Epub 2020 Apr 17.

Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Purpose: The most frequent impact sites for head injury patients who require surgical intervention are the temporo-parietal regions. However, most recent guidelines for indication of neuroimaging for head injury sparsely address the impact site as a risk factor. Our purpose was to determine the association between the site of impact in a minor mechanism pediatric head injury and neurosurgical intervention. Read More

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http://dx.doi.org/10.1007/s00381-020-04612-8DOI Listing

The Challenges of Ultrasound-guided Thoracic Paravertebral Blocks in Rib Fracture Patients.

Cureus 2020 Apr 10;12(4):e7626. Epub 2020 Apr 10.

Anesthesiology, Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, USA.

Thoracic paravertebral blocks (TPVBs) provide an effective pain relief modality in conditions where thoracic epidurals are contraindicated. Historically, TPVBs were placed relying solely on the landmark-based technique, but the availability of ultrasound imaging makes it a valuable and practical tool during the placement of these blocks. TPVBs also provide numerous advantages over thoracic epidurals, namely, minimal hypotension, absence of urinary retention, lack of motor weakness, and remote risk of an epidural hematoma. Read More

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http://dx.doi.org/10.7759/cureus.7626DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153808PMC

Midline spinous process splitting laminoplasty in a newborn with thoracolumbar epidural hematoma: a bone-sparing procedure based on anatomy and embryology.

Childs Nerv Syst 2020 Apr 14. Epub 2020 Apr 14.

Service of Neurosurgery, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.

Spinal epidural hematoma (SEH) is a rare condition leading to spinal cord compression after trauma, surgery, or other. In 40% of the cases, the cause is unknown or unidentified. Due to the absence of specific symptoms, the diagnosis is often delayed. Read More

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http://dx.doi.org/10.1007/s00381-020-04611-9DOI Listing
April 2020
1.163 Impact Factor

Neuraxial anesthesia is associated with improved survival after total joint arthroplasty depending on frailty: a cohort study.

Reg Anesth Pain Med 2020 Jun 7;45(6):405-411. Epub 2020 Apr 7.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Background: Frailty increases risk for complications after total joint arthroplasty (TJA). Whether this association is influenced by anesthetic administered is unknown. We hypothesized that use of neuraxial (spinal or epidural) anesthesia is associated with better outcomes compared with general anesthesia, and that the effect of anesthesia type on outcomes differs by frailty status. Read More

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http://dx.doi.org/10.1136/rapm-2019-101250DOI Listing

Thrombocytopenia in Surgery and Neuraxial Anesthesia.

Authors:
Lise J Estcourt

Semin Thromb Hemost 2020 Apr 7;46(3):245-255. Epub 2020 Apr 7.

NHS Blood and Transplant, Oxford, United Kingdom.

This is a review of the evidence for the use of different platelet count thresholds prior to invasive procedures and surgery. This review will focus on three procedures that are common in patients with thrombocytopenia-central venous catheter insertion, liver biopsy, and lumbar punctures and epidural catheters-as well as highlighting the lack of evidence for more major surgery. Tunneled or untunneled central venous catheters are low-risk procedures and can be safely performed without any intervention when the platelet count is 20 × 10/L or above. Read More

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http://dx.doi.org/10.1055/s-0040-1702918DOI Listing

Robot-Assisted Instrumented Fusion of a T8-9 Extension Distraction Fracture and Epidural Hematoma Evacuation: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2020 Apr 7. Epub 2020 Apr 7.

Department of Neurosurgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania.

The utilization of robotics has been gaining increased popularity in spine surgery. It can be used to assist in pedicle screw insertion when anatomy is complex in deformity surgery, but is also helpful in degenerative spine as it can minimize tissue dissection and fluoroscopy use.1-6 We present an operative video that demonstrates the use of a robotic system (Globus Excelsius GPS, Audubon, Pennsylvania) for thoracic instrumentation in an unstable fracture. Read More

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http://dx.doi.org/10.1093/ons/opaa061DOI Listing

Symptomatic Intrathecal Hematoma following an Epidural Blood Patch for an Obstetric Patient with Postdural Puncture Headache: A Case Report and Synthesis of the Literature.

Case Rep Anesthesiol 2020 18;2020:8925731. Epub 2020 Mar 18.

Department of Anesthesia, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11794, USA.

Epidural blood patch (EBP), generally considered a low-risk procedure, can potentially lead to significant neurological complications. We report the case of a parturient who underwent an uneventful EBP for postdural puncture headache (PDPH) and subsequently presented with progressively worsening radicular symptoms. Magnetic resonance imaging (MRI) revealed an intrathecal hematoma, and conservative management with steroids led to complete recovery. Read More

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http://dx.doi.org/10.1155/2020/8925731DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104125PMC

Pregnancy with Fontan circulation: A report of case series in Japan.

J Cardiol Cases 2020 Apr 30;21(4):161-163. Epub 2019 Dec 30.

Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Owing to new surgical procedures and medications, more women who have undergone the Fontan procedure reach childbearing ages. We report five cases of pregnancy with Fontan circulation. Case 1 had subchorionic hematoma (SCH), fetal growth restriction (FGR), and preterm labor (PTL). Read More

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http://dx.doi.org/10.1016/j.jccase.2019.12.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7125375PMC

Spinal Anesthetic in a Patient With a Platelet Count of 7000 × 109/L and Undiagnosed Thrombotic Thrombocytopenic Purpura: A Case Report.

A A Pract 2020 Apr;14(6):e01184

From the Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

A parturient with unknown thrombotic thrombocytopenic purpura (TTP) received spinal anesthesia for cesarean delivery with subsequent discovery of a platelet count of 7000 × 10/L. Neurologic recovery was normal. Limited data exist to determine the risk of spinal epidural hematoma (SEH) in severely thrombocytopenic patients because they often receive alternate labor analgesia or general anesthesia during cesarean delivery. Read More

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http://dx.doi.org/10.1213/XAA.0000000000001184DOI Listing

Spontaneous Intracranial Hypotension: Case Study and Review of the Literature.

Cureus 2020 Feb 17;12(2):e7018. Epub 2020 Feb 17.

Neurosurgery, Kaiser Permanente Fontana Medical Center, Fontana, USA.

Spontaneous intracranial hypotension (SIH) is a pathology characterized by orthostatic headaches, diffuse pachymeningeal enhancement on magnetic resonance imaging (MRI), and low to normal cerebrospinal fluid (CSF) pressures. We present the case of a 46-year-old male with refractory postural headaches, found to have a diffuse CSF leak throughout the cervicothoracic (C1-T12) spine. His neurological status declined rapidly to a Glasgow Coma Scale (GCS) of eight, necessitating bilateral subdural drain placement. Read More

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http://dx.doi.org/10.7759/cureus.7018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081740PMC
February 2020

The Initial Factors with Strong Predictive Value in Relation to Six-Month Outcome among Patients Operated due to Extra-Axial Hematomas.

Diagnostics (Basel) 2020 Mar 23;10(3). Epub 2020 Mar 23.

Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland.

Introduction: Traumatic brain injuries (TBI) are a real social problem, with an upward trend worldwide. The most frequent consequence of a traumatic brain injury is extra-axial hemorrhage, i.e. Read More

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http://dx.doi.org/10.3390/diagnostics10030174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151066PMC

A Case Report: An Acute Spinal Epidural Hematoma after Acupuncture Mimicking Stroke.

J Emerg Med 2020 Apr 20;58(4):e185-e188. Epub 2020 Mar 20.

Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Dementia and Parkinson's Disease Integrated Center, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.

Background: Spinal epidural hematoma (SEH) after acupuncture is rare and may present with acute or subacute onset and varied symptoms, making it difficult to diagnose. This condition can mimic acute stroke, so it is vital to establish a clear diagnosis before considering thrombolytic therapy, which could be disastrous if applied inappropriately.

Case Report: We describe a 52-year-old man who presented to our emergency department (ED) with acute onset of unilateral weakness of the limbs for 3. Read More

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http://dx.doi.org/10.1016/j.jemermed.2020.01.009DOI Listing

Spinal Epidural Hematoma Secondary to Tenecteplase for ST-Elevation Myocardial Infarction in the Setting of Trauma and Cervical Endplate Fracture.

CJC Open 2020 Mar 28;2(2):71-73. Epub 2019 Dec 28.

Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

A 78-year-old woman presented with an inferior ST-segment elevation myocardial infarction in the setting of a fall resulting in facial trauma causing an unrecognized C6 cervical endplate fracture. After administration of tenecteplase, she developed a spinal epidural hematoma requiring intubation for airway protection and cessation of antiplatelet therapies. The need to delay coronary intervention in this setting led to a recurrent inferolateral ST-segment elevation myocardial infarction that eventually required coronary bypass grafting. Read More

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http://dx.doi.org/10.1016/j.cjco.2019.12.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067686PMC