Search Our Scientific Publications & Authors

Clin J Pain 2019 Apr 18. Epub 2019 Apr 18.

The Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.

Objectives: The risks of epidural analgesia differ depending on the population studied. We describe our experience with postoperative epidural analgesia for oncologic surgery.

Materials And Methods: After approval from the Institutional Review Board of The University of Texas MD Anderson Cancer Center to conduct this retrospective analysis, we searched our acute pain medicine database for cases in which postoperative epidural analgesia was used between 2003 and 2012. Read More

Reg Anesth Pain Med 2019 Apr 16. Epub 2019 Apr 16.

Anesthesiology, Clement Zablocki VA Medical Center/Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Stellate ganglion nerve blockade (SGNB) is a vital tool in our armamentarium for the treatment of various chronic pain syndromes. SGNB can be performed using the traditional landmark-based approach, or with image guidance using either fluoroscopy or ultrasound. In this review, we systematically analyzed reported SGNB-related complications between 1990 and 2018. Read More

Asian J Neurosurg 2019 Jan-Mar;14(1):286-288

Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Spontaneous cervical epidural hematoma (SCEH), which is a rare disease, is manifested as by a sudden quadriplegia or paraplegia and other neurological deficits. SCEH can compress the spinal cord resulting in its clinical manifestations. The reported etiological risk factors are anticoagulants, coagulopathies, vascular malformations, infections, and herniated discs. Read More

World Neurosurg 2019 Mar 28. Epub 2019 Mar 28.

Division of Neurosurgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.

Introduction: Radiculo-medullary arteries aneurysms are rare, with only few cases previously reported.

Case Report: We report the case of a 54-year-old woman with sudden onset of upper thoracic back pain. MRI/MRA of the spine showed a cervico-thoraco-lumbar hematoma, with no evidence of underlying vascular malformations. Read More

Spine J 2019 Mar 16. Epub 2019 Mar 16.

Department of Orthopaedics and Sport Medicine, Harborview Medical Center, 325 Ninth Avenue Seattle, WA 98104, USA. Electronic address:

Background: Ankylosing spinal disorder (ASD) patients are at a greater risk for spinal fractures due to osteoporosis and rigidity of the spinal column. These fractures are associated with a high risk of neurologic compromise resulting from delayed or missed diagnoses. Although computed tomography (CT) is usually the initial imaging modality, magnetic resonance imaging (MRI) has been proposed as mandatory to help identify spinal injuries in ASD patients with unexplained neck or back pain or known injuries to help identify noncontiguous fractures. Read More

World Neurosurg 2019 Mar 14. Epub 2019 Mar 14.

Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea.

Background: Symptomatic postoperative spinal epidural hematoma is a serious complication that may occur after lumbar spine surgery. We analyzed epidural hematoma using postoperative magnetic resonance imaging (MRI) after biportal endoscopic spinal surgery and its impact on clinical outcome.

Methods: The subjects of this study were 158 patients who underwent single-level decompression using the biportal endoscopic spinal surgery technique from 2015 to 2017. Read More

Neurol Sci 2019 Mar 7. Epub 2019 Mar 7.

Neurology Service and Stroke Unit, Department of Neuroscience, AO Brotzu, Cagliari, Italy.

Background: Intracranial hypotension has been associated with a wide spectrum of neurological conditions including chronic non-aneurysmal and acute aneurysmal subarachnoid hemorrhage.

Case: A 59-year-old man presented with a non-aneurysmal subarachnoid hemorrhage in a perimesencephalic pattern after a mild physical exertion. In the course of the disease, a magnetic resonance imaging of head and spine displayed intracranial hypotension that resolved spontaneously. Read More

Radiol Clin North Am 2019 Mar 5;57(2):397-413. Epub 2018 Dec 5.

Department of Radiology and Imaging Sciences, University of Utah, 30 North 1900 East, Room 1A71, Salt Lake City, UT 84132, USA. Electronic address:

Acute low back pain, defined as less than 6 weeks in duration, does not require imaging in the absence of "red flags" that may indicate a cause, such as fracture, infection, or malignancy. When imaging is indicated, it is important to rule out a host of abnormalities that may be responsible for the pain and any associated symptoms. A common mnemonic VINDICATE can help ensure a thorough consideration of the possible causes. Read More

Radiographics 2019 Mar-Apr;39(2):449-466. Epub 2019 Feb 1.

From the Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.

The biomechanical stability of the spine is altered in patients with a rigid spine, rendering it vulnerable to fracture even from relatively minor impact. The rigid spine entities are ankylosing spondylitis (AS), diffuse idiopathic skeletal hyperostosis, degenerative spondylosis, and a surgically fused spine. The most common mechanism of injury resulting in fracture is hyperextension, which often leads to unstable injury in patients with a rigid spine per the recent AOSpine classification system. Read More

Am J Emerg Med 2019 Apr 15;37(4):797.e1-797.e4. Epub 2019 Jan 15.

Truman Medical Center, Department of Emergency Medicine, University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, Mo, USA. Electronic address:

Background: Spinal epidural hematoma (SEH) is an uncommon but serious emergency condition rare cases of spontaneously or following a minor traumatic event without bony injury.

Objective: We report the rare case of SEH associated with traditional massage initially presenting with delayed lower paraplegia.

Case Report: A 20-year-old man presented with bilateral lower extremity weakness and numbness 3 h prior to presentation. Read More

Neurochirurgie 2019 Feb 8;65(1):27-31. Epub 2019 Jan 8.

Department of Orthopaedics, Shanghai Changzheng Hospital, Second Military Medical University, No. 415, Feng Yang Street, Huangpu District, Shanghai 200003, China.

Objective: To present the natural course and treatment modalities of spontaneous cervical epidural hematoma (SCEH), by reporting two rare cases with spontaneous resolution in both clinical and radiologic findings without surgery.

Material And Methods: One patient presenting with acute right side hemiparesis and another showing pure cervical radiculopathy were diagnosed with SCEH on magnetic resonance imaging (MRI). Both were both treated non-operatively. Read More

Surg Neurol Int 2018 19;9:229. Epub 2018 Nov 19.

Department of Neurosurgery, Clinical Neurosciences Center, Salt Lake City, Utah, USA.

Background: Bilateral blunt cerebrovascular injury (BCVI) has been documented in 32 patients in the English-language literature and bilateral carotid-cavernous fistulae (CCFs) have been reported in only 1 patient. Here, we present a case of severe, unexpected bilateral BCVI with bilateral direct CCF and review the literature of BCVI, particularly cases of bilateral injury.

Case Description: A 65-year-old woman with episodic bradycardia presented after a motor vehicle accident. Read More

BMJ Case Rep 2018 Dec 3;11(1). Epub 2018 Dec 3.

Department of Neurosurgery, Neurosurgical Teaching Hospital, Baghdad, Iraq.

A man, a teenage victim of an assault to the head, presented to the emergency department, in Baghdad, with a Glasgow Coma Score of 4/15 (E1 M2 V1) and total right-sided paralysis. CT of the brain revealed a large-left sided frontotemporoparietal extradural haematoma with the presence of an ipsilateral sylvian arachnoid cyst deep to the haematoma. Urgent surgical evacuation of the haematoma was performed, leaving the arachnoid cyst intact. Read More

Case Rep Obstet Gynecol 2018 7;2018:5879481. Epub 2018 Nov 7.

Department of Neurology, White Memorial Medical Center, Los Angeles, CA 90033, USA.

Background: Spontaneous epidural hematoma (SEH) is a rare finding in pregnancy, especially since most pregnant women do not have risk factors for developing SEH. The presence of epidural anesthesia can delay the diagnosis of SEH in pregnant patients. Immediate surgical decompression is the current standard of care for treating SEH. Read More

World Neurosurg 2019 Mar 3;123:1-6. Epub 2018 Dec 3.

Department of Neurological Surgery, Policlinico "G. Rodolico" University Hospital, Catania, Italy.

Background: Arachnoiditis ossificans (AO) is a rare condition often associated with previous spine surgery. Here we describe a unique case of a patient affected by ankylosing spondylitis (AS), presenting with progressive neurologic deterioration due to AO. We also review the literature on evaluation and management of patients suffering from AO. Read More

Surg Neurol Int 2018 23;9:213. Epub 2018 Oct 23.

Department of Neurosurgery, Riverside University Health System, Riverside, California, USA.

Background: Brown-Sequard syndrome (BSS) is a well-known entity that is most commonly caused by a penetrating injury to the spinal cord (e.g., stab wound or gunshot wound). Read More

World Neurosurg 2019 Mar 23;123:e162-e170. Epub 2018 Nov 23.

Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.

Background: In patients with ankylosing spinal disease, including ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis, even low-impact trauma can lead to complex injuries. The injuries seem to be highly unstable and associated with greater mortality rates compared with the general spine trauma population.

Methods: We reviewed the medical records of a consecutive series of 41 patients (34 men, 7 women) with ankylosing spinal disease and unstable traumatic spine injuries who were admitted to our department from 2007 to 2016. Read More

Childs Nerv Syst 2019 May 15;35(5):889-891. Epub 2018 Nov 15.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.

Introduction: Hunter syndrome (HS) is a rare X-linked lysosomal storage disorder which affects multiple organ systems. Surgical intervention and general anesthesia should be used with caution because of significant airway complications.

Case Report: Two HS patients underwent surgery with different prognosis are presented below. Read More

Rozhl Chir Spring 2018;97(6):267-272

Introduction: Epidural hematoma (EDH) is generally considered to be a condition with a good prognosis. However, postoperative results of numerous studies have shown that mortality and morbidity remain relatively high. The aim of our article is to evaluate surgical outcomes in patients undergoing EDH evacuation over the last five years. Read More

Br J Radiol 2019 Mar 27;92(1095):20180532. Epub 2018 Nov 27.

1 Department of Radiology, Mater Misericordiae University Hospital , Dublin , Ireland.

Spinal haematoma is a rare occurrence, however has the potential to cause significant spinal injury and morbidity. MRI is the gold-standard of investigation, and urgent imaging is required for early diagnosis and treatment to ensure best patient outcomes. We present a pictorial review demonstrating the imaging features of spinal haematoma based on meningeal space assignment; epidural, subdural, subarachnoid, intramedullary and a combination of these locations. Read More

Medicine (Baltimore) 2018 Nov;97(45):e13090

Department of Physical Medicine and Rehabilitation, Spine Center, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.

Rationale: Epidural hematoma is a possible complication after neuraxial procedures. Recently, caudal epidural pulsed radiofrequency (PRF) stimulation was reported as an effective method for controlling several types of chronic pain. Herein, we report on a patient who developed a lumbar epidural hematoma after receiving caudal epidural PRF stimulation. Read More

World Neurosurg 2019 Feb 4;122:272-277. Epub 2018 Nov 4.

Department of Neurosurgery, Institute of Neurosciences, Medanta the Medicity, Gurgaon, Haryana, India.

Background: Neurologic complications are increasingly being reported in dengue epidemics. Intraspinal hematomas are rare, and those associated with dengue fever are still rarer with only 1 being reported in the literature.

Case Description: We report a case of dengue fever presenting with acute-onset quadriparesis (upper limbs Medical Research Council [MRC] 4/5 and lower limbs 0/5) and urinary incontinence. Read More

Korean J Neurotrauma 2018 Oct 31;14(2):80-85. Epub 2018 Oct 31.

Department of Obstetrics and Gynecology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.

Objective: The objective of this study was to reinterpret the neurodevelopmental prognostic factors that are associated with birth head injury by performing a long-term follow-up.

Methods: Seventy-three neonates with head injuries were retrospectively analyzed after a duration of 10.0±7. Read More

J Clin Neurosci 2019 Jan 2;59:270-275. Epub 2018 Nov 2.

The University of Tokyo Hospital, Japan.

Spontaneous spinal epidural hematoma (SSEH) in the cervical spine is rare, and it remains unclear how this condition resolves. We aimed to elucidate the underlying pathology of SSEH conservatively treated using magnetic resonance imaging (MRI) analysis. We reviewed the clinical records of patients with SSEH treated conservatively between January 2011 and November 2016 and analyzed the patients' medical history, medication, spinal cord compression on MRI, and neurological status. Read More

J Neurointerv Surg 2019 Mar 2;11(3):307-312. Epub 2018 Nov 2.

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Background: Venous stenting has been proven to be a safe and effective therapeutic option for patients with idiopathic intracranial hypertension (IIH) and cerebral venous sinus stenosis (CVSS). However, its use in patients with cerebral venous sinus thrombosis-related CVSS has been less reported.

Purpose: To explore the safety and efficacy of stenting for patients with cerebral venous sinus thrombosis (CVST)-related CVSS. Read More

BMC Complement Altern Med 2018 Oct 29;18(1):291. Epub 2018 Oct 29.

Department of Orthopaedics, Hanil General Hospital, 308 Uicheon-ro, Dobong-Gu, Seoul, 132-703, South Korea.

Background: Spontaneous spinal epidural hematoma (SSEH) is an uncommon disease, but it can lead to acute cord compression with disabling consequences. Identifiable reasons for spontaneous hemorrhage are vascular malformations and bleeding disorders. However, SSEH after taking herbal medicines has not been described yet. Read More

Med Sci Monit 2018 Oct 19;24:7469-7474. Epub 2018 Oct 19.

Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China (mainland).

BACKGROUND Moyamoya disease (MMD) is an idiopathic disease caused by progressive steno-occlusion of the distal internal carotid artery. Ideal surgical treatment for adult patients with ischemic-type MMD has not been achieved. The aim of this study was to evaluate the efficacy of single-barrel superficial temporal artery-middle cerebral artery (STA-MCA) bypass in treatment for adult patients with ischemic-type MMD by analyzing clinical and radiological data retrospectively. Read More

World Neurosurg 2019 Feb 16;122:e241-e247. Epub 2018 Oct 16.

Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Objective: Spontaneous spinal epidural hematoma (SSEH) is a rare and morbid entity, with the prognosis affected by delayed diagnosis and surgical intervention. The correlation between the timing of the intervention and neurological recovery has not been clearly reported. We present a retrospective study of SSEH to determine the correlation between the timing of surgical intervention and changes in the spinal cord signal on magnetic resonance imaging (MRI) with the neurological outcome. Read More

World Neurosurg 2019 Jan 13;121:e954-e961. Epub 2018 Oct 13.

Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Objective: We studied the postoperative morphology of the dura mater and analyzed the probability of epidural hematoma (EH) after anterior controllable antedisplacement and fusion (ACAF).

Methods: A total of 63 patients with a diagnosis of ossification of the posterior longitudinal ligament (OPLL) and degenerative kyphosis and stenosis (DKS) had undergone ACAF from 2016 to 2017. All these patients had undergone cervical plain films, computed tomography, and magnetic resonance imaging (MRI). Read More

World Neurosurg 2019 Jan 10;121:95-96. Epub 2018 Oct 10.

Government Medical College and Hospital, Chandigarh, India. Electronic address:

"Swirl sign" is a relatively uncommon sign, seen on noncontrast CT scan in patients of head trauma who develop extradural hematoma. It has 2 components: hyperacute, which represents ongoing active intracranial bleed, and acute, which comprises surrounding hyperattenuated clotted blood. The importance of early identification of this sign by surgeons and aggressive surgical management might have a bearing on the prognosis and survival of the patients, as emphasized here by 2 clinical scenarios. Read More

World Neurosurg 2019 Jan 5;121:e700-e711. Epub 2018 Oct 5.

Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan.

Objective: The diagnosis and treatment of intracranial hypotension associated with a spinal cerebrospinal fluid (CSF) leak, especially in comatose patients, have yet to be established.

Methods: Clinical manifestations, neuroimaging findings, and treatment outcomes in 11 patients (Glasgow Coma Scale score 10 ± 4) were described and compared with 36 patients with normal consciousness.

Results: Patients with disturbed consciousness were diagnosed at a significantly older age (55 ± 11 years; P < 0. Read More

Asian J Neurosurg 2018 Jul-Sep;13(3):870-872

Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan.

A case of delayed occurrence of C3 vertebra anterior subluxation diagnosed 10 days after surgery for epidural hematoma is herein described. A 56-year-old man underwent surgery for right epidural hematoma. No spinal fracture was identified on the cervical-spinal computed tomography (CT) on arrival. Read More

Int J Spine Surg 2018 Jan 30;12(1):26-29. Epub 2018 Mar 30.

Department of Neurosurgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Spontaneous cervical epidural hematoma is an uncommon cause of acute spinal cord compression. This is a rare idiopathic condition that leads to acute onset of neurologic deficits, which if not recognized early can have catastrophic consequences. Acute cervical epidural hematoma is definitely a condition of neurologic emergency. Read More

World Neurosurg 2018 Dec 26;120:500-505. Epub 2018 Sep 26.

Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Republic of Korea.

Background: Kummell disease is defined as avascular necrosis of vertebra, occurs after the delayed posttraumatic osteoporotic vertebral collapse, and mainly occurs in adults older than 50 years of age. We report the first case of refracture of Kummell disease and epidural hematoma followed by paraparesis.

Case Description: A 67-year-old woman with a known case of osteoporotic T12 fracture (3 months back) visited our outpatient clinic complaining of persistent back pain and paraparesis after jerking while getting up from the bed. Read More

Headache 2018 Sep 20;58(8):1244-1255. Epub 2018 Sep 20.

Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, PR. China.

Objective: Spontaneous intracranial hypotension is a risk factor for cerebral venous thrombosis. The occurrence of cerebral venous thrombosis in patients with spontaneous intracranial hypotension raises difficult practical questions regarding the management of the 2 conditions. We reviewed our experience and the relevant literature to evaluate these related questions. Read More

Radiographics 2018 Sep-Oct;38(5):1516-1535

From the Departments of Radiology and Medical Imaging (J.L.P., J.H.D., N.C.N., C.R.Q., M.T.P., N.F., M.D.M., C.A.S.) and Orthopedic Surgery (G.A.F., F.H.S.), University of Virginia, 1215 Lee St, Charlottesville, VA 22908.

Spinal hematomas are a frequent indication for radiologic evaluation and can be a diagnostic dilemma for many radiologists and surgeons. There are four types of spinal hematomas: epidural, subdural, subarachnoid, and intramedullary (spinal cord) hematomas. Because they differ by their location in relationship to the meningeal membranes and spinal cord, unique radiologic appearances can be recognized to distinguish these types of spinal hemorrhage. Read More

Medicine (Baltimore) 2018 Sep;97(36):e11587

Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

Rationale: Deep cerebral venous thrombosis (DCVT) is a rare disease, but always results in poor prognosis.

Patient Concerns: We reported a 79-year-old female with coma after traumatic brain injury (TBI).

Diagnosis: The epidural hematoma was first diagnosed on non-contrast computerized tomography (CT). Read More

Childs Nerv Syst 2019 Feb 8;35(2):379-383. Epub 2018 Sep 8.

Department of Orthopaedic Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.

Spontaneous spinal epidural hematoma (SSEH) very rarely develops in infants younger than 1 year old. To our knowledge, no previous case of delayed-onset paralysis induced by SSEH communicated with hematoma in the paraspinal muscle has been reported in the literature. The authors present the case of a 6-month-old girl with a tumor mass on her back who developed a paresis of her bilateral lower limbs. Read More

Turk Neurosurg 2018 ;28(4):678-681

Tehran University of Medical Sciences, Imam Khomeini Hospital, Department of Neurological Surgery, Tehran, Iran.

Neurological injury is a potential complication of anterior cervical discectomy (ACDF). Iatrogenic trauma, hypoxic-ischemic damage during surgery or epidural hematoma could cause neurological deterioration after surgery. This is the first case being reported of neurological deterioration after an anterior cervical discectomy due to ligamentum flavum buckling. Read More

Clin Orthop Surg 2018 Sep 22;10(3):380-384. Epub 2018 Aug 22.

Department of Orthopedics, Seoul Sacred Heart General Hospital, Seoul, Korea.

Background: The incidence of cardiovascular and neurovascular diseases has been increasing with the aging of the population, and antiplatelet drugs (APDs) are more frequently used than in the past. With the average age of spinal surgery patients also increasing, there has been a great concern on the adverse effects of APD on spine surgery. To our knowledge, though there have been many studies on this issue, their results are conflicting. Read More

BMJ Case Rep 2018 Aug 29;2018. Epub 2018 Aug 29.

Department of Neurosurgery, Augusta University Medical College of Georgia, Augusta, Georgia, USA.

An African American teenage boy during an acute sickle cell crisis spontaneously developed acute bifrontal epidural haematomas (EDHs) in addition to disseminated intravascular coagulation (DIC). The successfully evacuated EDH reaccumulated postoperatively. After multiple transfusions, the patient underwent repeat surgery. Read More

Am J Case Rep 2018 Aug 29;19:1030-1034. Epub 2018 Aug 29.

Department of Neurosurgery, Huishan People's Hospital of Wuxi, Wuxi, Jiangsu, China (mainland).

BACKGROUND Traumatic torcular herophili epidural hematoma is a rare and specific type of traumatic brain injury that is technically difficult to treat and, more critically, can lead to malignant encephalocele during the operation. CASE REPORT A 40-year-old man presented to our hospital 2 h after a motor vehicle crash. Emergency cranial CT showed a frontotemporal subdural hematoma; 3 h after the patient was admitted, the GCS score decreased to 8 and cranial CT re-examination showed that the frontotemporal subdural hematoma was significantly larger than before. Read More

Pediatrics 2018 Sep;142(3)

Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah.

Background And Objectives: Guidelines regarding the role of repeated head computed tomography (CT) imaging in the nonoperative management of traumatic epidural hematomas (EDHs) do not exist. Consequently, some children may be exposed to unnecessary additional ionizing radiation. We describe the frequency, timing, and utility of reimaging of EDHs to identify patients who might avoid reimaging. Read More

World Neurosurg 2018 Dec 23;120:82-89. Epub 2018 Aug 23.

Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Shizuoka, Japan.

Background: Spinal epidural hematoma (SEH) is a potentially devastating problem that requires rapid diagnosis and surgical intervention. A chronic course is rarely seen following SEH, and the clinical characteristics are quite different from acute cases. The epidemiology, clinical history, and radiologic findings of chronic SEH (CSEH) are not well understood, although the detection rate has increased with the widespread use of magnetic resonance imaging. Read More

Spine J 2019 Mar 23;19(3):403-410. Epub 2018 Aug 23.

Department of Orthopedics, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.

Purpose: To assess whether a focused magnetic resonance imaging (MRI) limited to the region of known acute traumatic thoracic or lumbar fracture(s) would miss any clinically significant injuries that would change patient management.

Study Design/setting: A multicenter retrospective clinical study.

Patient Sample: Adult patients with acute traumatic thoracic and/or lumbar spine fracture(s). Read More

Turk J Anaesthesiol Reanim 2018 Aug 1;46(4):319-322. Epub 2018 Aug 1.

Department of Anaesthesiology and Reanimation, Division of Algology, Dokuz Eylül University School of Medicine, İzmir, Turkey.

Haemorrhage in the neuraxial region following spinal and epidural interventions is a rare and unexpected complication. Subdural haemorrhage is the most frequently occurring type. A 64-year-old male patient was admitted with complaints of severe headache and intermittent fever after 14 days of spinal anaesthesia and inguinal hernia operation. Read More

BMJ Case Rep 2018 Aug 23;2018. Epub 2018 Aug 23.

General Internal Medicine, Muribushi Okinawa for Teaching Hospitals, Urasoe, Okinawa, Japan.

Indian J Crit Care Med 2018 Jul;22(7):555-557

Department of Anaesthesiology and Surgical Oncology, Saifee Hospital, Mumbai, Maharashtra, India.

Coagulopathy either from the use of anticoagulant, antiplatelet, or thrombolytic medications or from underlying medical conditions is considered one of the major risk factors for epidural hematoma formation related to epidural catheter placement or removal. The American Society of Regional Anesthesia and Pain Medicine (ASRA) has laid down guidelines regarding timing of neuraxial blockade or removal of neuraxial catheters in patients receiving either antithrombotic or thrombolytic therapy. We present a case of acute onset of paraplegia because of an epidural hematoma following removal of the epidural catheter in a patient who was given the first dose of antithrombotic therapy after the removal of the epidural catheter as per the ASRA guidelines. Read More

World Neurosurg 2018 Oct 25;118:269-273. Epub 2018 Jul 25.

Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.

Background: Difficulties are associated with the diagnosis and management of patients with coma because of intracranial hypotension.

Case Description: A 70-year-old man with coma (Glasgow Coma Scale score of 6) with fixed dilated pupils because of severe intracranial hypotension is described. After unsuccessful epidural blood patch (EBP), the patient underwent microsurgical dural repair and drainage of hematoma with intracranial pressure (ICP) monitoring. Read More

EJIFCC 2018 Jul 11;29(2):146-151. Epub 2018 Jul 11.

Division of Angiology, Department of Internal Medicine, Medical University of Graz, Austria.

We report a case of severe central nervous system bleeding in a patient with acute monocytic leukemia. The patient was admitted to our emergency department because of massive back pain and positive meningeal signs. MR imaging yielded a spontaneous epidural hematoma of the thoracic vertebral column. Read More