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Deep Cervical Artery as a Source of Bleeding in Postoperative Spinal Epidural Hematoma: A Case Report

Motohisa Koga1,2, Gohsuke Hattori1, Mitsuhide Maeda1,2

  • 1Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.

NMC Case Report Journal
|August 17, 2019
PubMed

Insights

Postoperative spinal epidural hematoma (pSEH) can stem from the deep cervical artery (DCA). Careful surgical technique and awareness of the DCA are crucial to prevent bleeding complications during cervical spine surgery.

Area of Science:

  • Neurosurgery
  • Vascular Anatomy

Background:

  • Postoperative spinal epidural hematoma (pSEH) is a rare but serious complication following spinal surgery.
  • The precise source of bleeding in pSEH is frequently unidentified, complicating management.

Observation:

  • A case of pSEH occurred in a patient who underwent cervical spine surgery for spondylotic myelopathy.
  • Intraoperative arterial hemorrhage from a deep cervical artery (DCA) branch was noted and hemostasis achieved.
  • A large pSEH developed postoperatively, necessitating surgical evacuation.

Findings:

  • The study suggests a distal branch of the deep cervical artery (DCA) as the potential source of bleeding in this pSEH case.
  • The placement and removal of the suction drain may have contributed to the delayed hemorrhage.
  • No active bleeding was observed during the hematoma evacuation surgery.

Implications:

  • Awareness of the deep cervical artery (DCA) is critical for neurosurgeons performing cervical spine procedures.
  • Meticulous hemostasis and careful dissection near the DCA and semispinalis cervicis muscle are essential.
  • Understanding potential bleeding sources can help prevent and manage pSEH more effectively.

Keywords:
deep cervical arterypostoperative spinal epidural hematoma

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