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Maddali P, Walker B, Fisahn C, et al. Subdural Thoracolumbar Spine Hematoma after Spinal Anesthesia: A Rare Occurrence and Literature Review of Spinal Hematomas after Spinal Anesthesia. Cureus. 2017;9(2):e1032doi: 10.7759/cureus.1032.
Maddali, P., Walker, B., Fisahn, C., Page, J., Diaz, V., Zwillman, M. E., Oskouian, R. J., Tubbs, R. S., & Moisi, M. (2017). Subdural Thoracolumbar Spine Hematoma after Spinal Anesthesia: A Rare Occurrence and Literature Review of Spinal Hematomas after Spinal Anesthesia. Cureus, 9(2), e1032. https://doi.org/10.7759/cureus.1032
Maddali, Prasanthi, et al. "Subdural Thoracolumbar Spine Hematoma after Spinal Anesthesia: A Rare Occurrence and Literature Review of Spinal Hematomas after Spinal Anesthesia." Cureus vol. 9,2 (2017): e1032. doi: https://doi.org/10.7759/cureus.1032
Maddali P, Walker B, Fisahn C, Page J, Diaz V, Zwillman ME, Oskouian RJ, Tubbs RS, Moisi M. Subdural Thoracolumbar Spine Hematoma after Spinal Anesthesia: A Rare Occurrence and Literature Review of Spinal Hematomas after Spinal Anesthesia. Cureus. 2017 Feb 16;9(2):e1032. doi: 10.7759/cureus.1032. PMID: 28357164; PMCID: PMC5354393.
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Cureus. 2017 Feb 16;9(2):e1032. doi: 10.7759/cureus.1032.

Subdural Thoracolumbar Spine Hematoma after Spinal Anesthesia: A Rare Occurrence and Literature Review of Spinal Hematomas after Spinal Anesthesia.

Cureus

Prasanthi Maddali, Blake Walker, Christian Fisahn, Jeni Page, Vicki Diaz, Michael E Zwillman, Rod J Oskouian, R Shane Tubbs, Marc Moisi

Affiliations

  1. Neurosurgery, Seattle Science Foundation.
  2. Neurological Surgery, Wayne State University.
  3. Orthopedic Surgery, Swedish Neuroscience Institute.
  4. Neurosurgery, Swedish Neuroscience Institute.
  5. Anesthesiology and Critical Care, Houston Methodist Hospital.
  6. Neurosurgery, Complex Spine, Swedish Neuroscience Institute.
  7. Seattle Science Foundation.

PMID: 28357164 PMCID: PMC5354393 DOI: 10.7759/cureus.1032

Abstract

Spinal hematomas are a rare but serious complication of spinal epidural anesthesia and are typically seen in the epidural space; however, they have been documented in the subdural space. Spinal subdural hematomas likely exist within a traumatically induced space within the dural border cell layer, rather than an anatomical subdural space. Spinal subdural hematomas present a dangerous clinical situation as they have the potential to cause significant compression of neural elements and can be easily mistaken for spinal epidural hematomas. Ultrasound can be an effective modality to diagnose subdural hematoma when no epidural blood is visualized. We have reviewed the literature and present a full literature review and a case presentation of an 82-year-old male who developed a thoracolumbar spinal subdural hematoma after spinal epidural anesthesia. Anticoagulant therapy is an important predisposing risk factor for spinal epidural hematomas and likely also predispose to spinal subdural hematomas. It is important to consider spinal subdural hematomas in addition to spinal epidural hematomas in patients who develop weakness after spinal epidural anesthesia, especially in patients who have received anticoagulation.

Keywords: spinal anesthesia; spinal epidural anesthesia; spinal epidural hematoma; spinal subdural hematoma

Conflict of interest statement

The authors have declared that no competing interests exist.

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