[Holospinal epidural haematoma following heart surgery]

Spinal epidural haematomas are rare entities associated to spinal traumatic injuries and vascular lesions or which can appear spontaneously. There are no direct reports linking them to heart surgery.

We report the case of a female aged 43 years who underwent surgery to change a mitral valve because of a rheumatic heart disease, and who, from the immediate post operative period onwards, presented paraplegia with a sensory and motor level that reached C3, breathing troubles and quadriplegia. Diagnosis was performed in five days because it was thought that she was suffering from an ischemic spinal cord infarction. Spiral computerised tomography scans revealed an epidural haematoma of the whole spinal cord from C2 to T12, with acute spinal cord compression. Ingurgitation of the epidural venous plexus and venous hypertension were also observed.

The study of a growing motor and sensory deficit in a patient with immediate heart surgery must include early imaging in order to rule out a space occupying pathology, such as a spinal epidural haematoma. This case is singular because of the extension involved and the fact that it is directly linked with heart surgery procedure.