Spinal epidural hematoma following epidural catheter removal in a paraplegic patient

Received 4 February 2008; received in revised form 29 November 2008; accepted 1 December 2008. published online 26 October 2009.

Abstract

Spinal epidural hematoma is a rare and devastating complication of epidural catheter removal in an anticoagulated patient. The diagnosis could be quite challenging, especially in patients with preexisting neurological deficits. A 35-year-old patient with remote spinal cord injury and T4 level paraplegia developed a spinal epidural hematoma on the 7th postoperative day. The hematoma developed after epidural catheter removal with concurrent administration of unfractionated heparin.

Keywords: Injury- Spinal cord, Paraplegia, Drugs- Anticoagulation, Subcutaneous unfractionated heparin, Administration error, Technique- Epidural anesthesia- analgesia, Complication- Spinal epidural hematoma

a Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada M4N 3M5

b Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada M4N 3M5

Corresponding author. Tel.: +1 416 480 4864; fax: +1 416 480 6039.

PII: S0952-8180(09)00257-8

doi:10.1016/j.jclinane.2008.12.020

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