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Local Anesthetics: Clinical Application as Epidural Anesthesia

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

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Multiple different remote epidural hematomas after craniotomy: A case report.

Qiang He¹, Chuan-Yuan Tao¹, Rui-Hong Fu²

¹Department of Neurosurgery, West China Hospital, Chengdu 610041, Sichuan Province, China.

World Journal of Clinical Cases

|March 23, 2022

Summary

This summary is machine-generated.

Multiple remote epidural hematomas after craniotomy are rare. This case highlights the need for vigilance and prompt diagnosis of this serious postoperative complication.

Keywords:

Case report Multiple epidural hematomas Postoperative complication Remote epidural hematoma Supratentorial and infratentorial regions

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Area of Science:

Neurosurgery
Neurology
Radiology

Background:

Epidural hematoma is a known complication following craniotomy.
Multiple remote epidural hematomas in distinct supratentorial and infratentorial locations are exceptionally rare.

Observation:

A 21-year-old female presented with headache, vomiting, and vision loss.
Preoperative MRI revealed a right thalamic tumor, with intraoperative findings including a cystic tumor, posterior cerebral artery aneurysm, and vascular malformation.
Postoperatively, the patient developed three remote epidural hematomas within 48 hours.

Findings:

The patient required surgical evacuation for the first two hematomas.
Family declined consent for the third hematoma evacuation.
This case underscores the potential for multiple, spatially distinct epidural hematomas after complex cranial surgery.

Implications:

Increased awareness of this rare complication is crucial for neurosurgical teams.
Thorough preoperative evaluation, especially in acute presentations, is essential.
Postoperative monitoring of neurological function and timely neuroimaging are critical for early detection and management.