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[Subarachnoid hematoma and spinal anesthesia].

A Dupeyrat1, P M Dequiré, A Mérouani

  • 1Département d'Anesthésie-Réanimation, CHU Côte de Nacre, Caen.

Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1990
PubMed
Summary
This summary is machine-generated.

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Spinal subarachnoid hematoma can occur after spinal anesthesia, particularly when anticoagulants are used. Early diagnosis is crucial for better outcomes, but it remains challenging, leading to poor prognoses, especially with paralysis.

Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Hematology

Context:

  • Spinal subarachnoid hematoma is a rare but serious complication.
  • Anticoagulant use, including prophylactic calcium heparinate, is a potential risk factor.
  • Two cases illustrate the challenges in diagnosis and management.

Purpose:

  • To report two cases of spinal subarachnoid hematoma following spinal anesthesia.
  • To highlight the potential role of anticoagulants in the development of these hematomas.
  • To discuss the diagnostic difficulties and poor prognosis associated with spinal cord compression.

Summary:

  • Two patients developed spinal subarachnoid hematoma after spinal anesthesia, with one case complicated by prophylactic calcium heparinate and the other by heparin treatment.

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  • Both patients experienced neurological deficits, including paraparesis and severe pain, leading to emergency laminectomy.
  • Despite surgical intervention, outcomes were poor, with partial recovery in one case and death in the other, underscoring the challenges of early diagnosis and management.

    • Impact:

    • These cases emphasize the critical need for vigilance regarding spinal subarachnoid hematoma in patients undergoing spinal anesthesia, especially those on anticoagulants.
    • The findings suggest that prompt diagnosis and intervention are vital for improving patient outcomes.
    • The study contributes to understanding the risks associated with spinal anesthesia and anticoagulant therapy, informing clinical practice and patient safety.