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Epidural hematoma

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https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#1
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079666/intravenous-tissue-plasminogen-activator-administration-for-ischemic-stroke-1-hour-after-epidural-catheter-removal-a-case-report
#2
Anne M Baciewicz, Calvin Lee, Alon Ben-Ari, Hojoong Kim, Alex T Lee
Anticoagulation after a recent neuraxial procedure poses risk for development of spinal hematoma. Clinical evidence supports prompt IV tissue plasminogen activator administration after onset of ischemic stroke. There is an absence of data regarding emergency fibrinolytic therapy for patients experiencing a stroke with recent neuraxial procedures, resulting in highly disparate, nonevidence-based guidelines. This report describes a patient who developed ischemic stroke when receiving postoperative epidural analgesia...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079662/recognition-of-a-thoracic-epidural-hematoma-in-the-setting-of-transient-paralysis-a-case-report
#3
Beth VanderWielen, Lindsay Rubenstein, Marc Shnider, Cindy Ku, Jason Wakakuwa
A 71-year-old woman on aspirin presented for a distal pancreatectomy, splenectomy, and partial colectomy with a T8/9 epidural catheter placed preoperatively in 3 attempts. Prophylactic 5000 units of subcutaneous heparin were given before the procedure. After catheter removal on postoperative day 2, the patient developed transient bilateral lower extremity paralysis, with near complete recovery within 30 minutes. An urgent MRI revealed a T4-T8 epidural hematoma prompting an emergent T3-T8 laminectomy. This case presentation highlights the need for heightened awareness regarding complications related to neuraxial analgesia in patients receiving unfractionated heparin for thromboembolism prophylaxis with concurrent aspirin use...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079571/spontaneous-intracranial-hypotension-with-site-of-leak-detected-only-after-111in-dtpa-cisternogram
#4
Sana Parsian, Manuela C Matesan, Sachin Shivaji Kumbhar, David H Lewis
A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. A left C2 root tie-off, targeted epidural blood patch, and Dura seal glue resulted in resolution of patient symptomatology highlighting the importance of fused SPECT/CT images in detection of an occult cerebral spinal fluid leak...
January 10, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28050641/children-presenting-in-delayed-fashion-after-minor-head-trauma-with-scalp-swelling-do-they-require-further-workup
#5
Jonathan N Sellin, Amee Moreno, Sheila L Ryan, Sandi K Lam, Marcella Donaruma-Kwoh, Thomas G Luerssen, Andrew Jea
PURPOSE: It is common to evaluate children who have sustained minor head trauma with computed tomography (CT) of the head. Scalp swelling, in particular, has been associated with intracranial injury. A subset of patients, however, present in delayed fashion, often days after the head trauma, as soft tissue edema progresses and their caregiver notices scalp swelling. We explore the value of further workup in this setting. METHODS: We conducted a retrospective review of a prospectively collected cohort of children ≤24 months of age presenting to the Texas Children's Hospital with scalp swelling more than 24 h following a head trauma...
January 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28049032/impact-of-helmet-use-on-severity-of-epidural-hematomas-in-cambodia
#6
Saksham Gupta, Vycheth Iv, Nang Sam, Din Vuthy, Katherine Klaric, Mark G Shrime, Kee B Park
No abstract text is available yet for this article.
December 31, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28025351/immediate-adverse-events-in-interventional-pain-procedures-a-multi-institutional-study
#7
Carrie M Carr, Christopher T Plastaras, Matthew J Pingree, Matthew Smuck, Timothy P Maus, Jennifer R Geske, Christine A El-Yahchouchi, Zachary L McCormick, David J Kennedy
SETTING: Interventional procedures directed toward sources of pain in the axial and appendicular musculoskeletal system are performed with increasing frequency. Despite the presence of evidence-based guidelines for such procedures, there are wide variations in practice. Case reports of serious complications such as spinal cord infarction or infection from spine injections lack appropriate context and create a misleading view of the risks of appropriately performed interventional pain procedures...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27997913/the-impact-of-diabetes-mellitus-on-patients-undergoing-cervical-spondylotic-myelopathy-a-meta-analysis
#8
Yang Liu, De-Xiang Ban, Shi-Lian Kan, Tai-Wei Cao, Shi-Qing Feng
AIMS: We conducted a meta-analysis of eligible studies to compare the surgical outcomes between diabetic patients and non-diabetic patients who have undergone cervical spondylotic myelopathy (CSM). METHODS: A systematic literature search of PubMed, Embase, and Web of Science (up to February 10, 2016) was conducted. Eligible studies were case-control or cohort studies that compared the outcomes of cervical surgery between diabetic patients and non-diabetic patients...
December 21, 2016: European Neurology
https://www.readbyqxmd.com/read/27994783/closed-drainage-versus-non-drainage-for-single-level-lumbar-disc-surgery-relationship-between-epidural-hematoma-and-fibrosis
#9
Kadir Kotil
STUDY DESIGN: A prospective clinical series with prospectively collected data. PURPOSE: The efficacy of using closed suction drains (CSD) after single-level lumbar disc surgery was evaluated. Postoperative CSD are regularly fitted to prevent postoperative epidural hematomas (EH) after multilevel lumbar decompression, although it remains unclear whether CSD also reduces postoperative EH following single-level lumbar disc surgery. OVERVIEW OF LITERATURE: Few articles have addressed the clinical outcome in patients with single-level lumbar disc disease who were treated by two different operative methods (with and without drainage)...
December 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27992010/spontaneous-intracranial-epidural-hematoma-during-rivaroxaban-treatment
#10
Leonardo Gilmone Ruschel, Felipe Marques Monteiro do Rego, Jerônimo Buzetti Milano, Gustavo Simiano Jung, Luis Fernando Silva, Ricardo Ramina
According to our research, this is the first case described in the literature of spontaneous intracranial epidural hematoma secondary to the use of Xareltor. Spontaneous intracranial epidural hematomas are rarely described in the literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura mater and metastasis to the skull. Long-term post-marketing monitoring and independent reports will probably detect the full spectrum of hemorrhagic complications of the use of rivaroxaban...
November 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27930523/anterior-cervical-discectomy-and-fusion-versus-anterior-cervical-corpectomy-and-fusion-in-multilevel-cervical-spondylotic-myelopathy-a-meta-analysis
#11
Tao Wang, Hui Wang, Sen Liu, Huang-Da An, Huan Liu, Wen-Yuan Ding
BACKGROUND: Both anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are used to treat multilevel cervical spondylotic myelopathy (mCSM); however, which one is better treatment for mCSM remains considerable controversy. A meta-analysis was performed to compare clinical outcomes, radiographic outcomes, and surgical outcomes between ACDF and ACCF in treatment for mCSM. METHODS: An extensive search of literature was performed in Pubmed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases on ACDF versus ACCF treatment for mCSM from January 2011 to August 2016...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27923756/chronic-spinal-subdural-hematoma-associated-with-antiplatelet-therapy-a-case-report
#12
Yukinori Akiyama, Izumi Koyanagi, Nobuhiro Mikuni
BACKGROUND: Spinal subdural hematoma is a rare clinical entity marked by the onset of pain and paralysis, which is usually associated with hemorrhagic disorders, trauma, and iatrogenic causes such as lumbar puncture or epidural anesthesia. CASE PRESENTATION: A 71-year-old male was admitted to our hospital with 2 weeks' history of bilateral lower leg pain, dysesthesia, paraparesis, and urinary disturbance. Magnetic resonance imaging revealed characteristic findings at the thoracolumbar spine, and surgical evacuation successfully treated this condition...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27923230/skull-subsidence-due-to-periosteum-defect-following-craniotomy-in-a-child
#13
Hidetaka Arishima, Ayumi Akazawa, Ken-Ichiro Kikuta
We report a case of a 7-year-old child with a cranial deformity secondary to a craniotomy for an intracranial hematoma. He suffered from an acute epidural hematoma with a lineal fracture of the right temporal bone following a severe head injury. A large question mark-shaped skin flap with the periosteum and temporal muscle was created for a decompressive craniectomy; however, neither the acute epidural hematoma nor brain swelling was severe, and we performed a small craniotomy compared with the skin flap without a decompressive craniectomy...
December 7, 2016: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27914160/infectious-postpartum-sacroiliitis-the-importance-and-difficulty-of-early-diagnosis
#14
Emídio Vale-Fernandes, Fedra Rodrigues, Carla Monteiro, Luís Carvalho
The sacroiliitis accounts for about 1.5% - 10% of all cases of septic arthritis and it is strongly associated with gynaecological infections, pelvic trauma or drug abuse (3.4% - 12.8% of cases occur during the postpartum period). Early diagnosis is difficult because the symptoms are nonspecific in pregnancy and in the postpartum period, making the delay of treatment a serious risk of irreversible damage to the joint and development of post-infectious complications. The authors describe the case of a 37-year-old puerperal woman presented to hospital, weeks after urgent caesarean section, with endometritis, post-anesthetic epidural hematoma and secondary infectious postpartum sacroiliitis...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27904723/why-cannot-suction-drains-prevent-postoperative-spinal-epidural-hematoma
#15
Dong Ki Ahn, Won Shik Shin, Jin Woo Kim, Seong Min Yi
BACKGROUND: Postoperative spinal epidural hematoma (POSEH) is different from spontaneous or post-spinal procedure hematoma because of the application of suction drains. However, it appeared that suction drains were not effective for prevention of POSEH in previous studies. The purpose of this study was to test our hypothesis that POSEH can be caused by hypercoagulability. METHODS: This was an experimental study. One hundred fifty milliliters of blood was donated from each of the 12 consecutive patients who underwent spine surgery and infused into 3 saline bags of 50 mL each...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27890764/spontaneous-spinal-epidural-hematoma-a-study-of-55-cases-focused-on-the-etiology-and-treatment-strategy
#16
Jiaxing Yu, Jiang Liu, Chuan He, Liyong Sun, Sishi Xiang, Yongjie Ma, Lisong Bian, Tao Hong, Jian Ren, Pengyu Tao, Jingwei Li, Guilin Li, Feng Ling, Hongqi Zhang
BACKGROUND: Spontaneous spinal epidural hematoma (SSEH) is a rare neurological emergency of the spinal cord. Its etiology and treatment strategy remain controversial. This study aimed to evaluate a significant cause of SSEH and to discuss the treatment strategy according to the clinical outcomes of patients in two institutions. METHODS: Fifty-five cases of SSEH treated at our institutions between February 2002 and February 2016 were retrospectively analyzed. RESULT: The mean age of the first SSEH onset was 31...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27876657/clinical-predictors-of-intracranial-injuries-in-infants-with-minor-head-trauma
#17
Hidenori Ohbuchi, Shinji Hagiwara, Kengo Hirota, Hirokazu Koseki, Yasuhiro Kuroi, Naoyuki Arai, Hidetoshi Kasuya
OBJECTIVE: Minor head trauma is common in children. Though most cases are nonsignificant, minor head trauma can lead to the deterioration of intracranial injuries, which is preventable. The aim of this study was to identify clinical predictors of intracranial injuries in infants with minor head trauma. METHODS: We retrospectively enrolled infants under 11 months with minor head trauma between 2006 and 2013. The following data were recorded: age, sex, cause of trauma, fall height, vomiting, bad temper, size and location of scalp hematoma, fracture, and intracranial injuries on CT...
November 19, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27865516/headholders-%C3%A2-%C3%A2-complications-in-neurosurgery-a-review-of-the-literature-and-recommendations-for-its-use
#18
REVIEW
P-A Beuriat, T Jacquesson, E Jouanneau, M Berhouma
Several types of headholders are routinely used in neurosurgical practice to secure the head in a precise position, providing better security during surgical dissection as well as an absence of eye compression during prone positions. Nevertheless, potentially lethal complications might occur. We performed a review of the literature via PubMed and Google Scholar using the terms "Mayfield skull clamp", "Sugita headholders", "headholder complications" and "skull clamp complications". Twenty-six complications directly related to the use of headholders were identified through 19 papers published from 1981 to 2014: mainly skull fractures with or without a dural laceration (50%), epidural hematomas (23...
December 2016: Neuro-Chirurgie
https://www.readbyqxmd.com/read/27861178/use-of-prothrombin-complex-concentrate-for-warfarin-reversal-before-the-performance-of-an-epidural-blood-patch-in-a-patient-with-cortical-vein-thrombosis-and-subdural-hematoma-a-case-report
#19
Kallol Chaudhuri, Cooper W Phillips, Swapna Chaudhuri, John Wasnick
Compared to conventional therapy, several studies with prothrombin complex concentrate (PCC) have recently demonstrated its superior efficacy in rapidly replacing vitamin K-dependent factors for patients with life-threatening hemorrhage. We present a novel use of PCC in a patient with intracranial hypotension, who had received warfarin for treatment of cortical vein thrombosis. However, after anticoagulation, she proceeded to develop bilateral subdural hematomas with descent of cerebellar tonsils. Given the possibility of an occult dural puncture during labor analgesia, an epidural blood patch was performed after administration of PCC and normalization of coagulation parameters, with prompt improvement of the patient's headache...
January 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/27858387/effects-of-discontinuance-of-preoperative-anti-platelet-medication-in-multi-level-thoracolumbar-spine-surgery
#20
Jun Seok Lee, Dong Wuk Son, Soon Ki Sung, Sang Weon Lee, Geun Sung Song
AIM: Our study aimed to evaluate the perioperative morbidities of patients taking anti-platelet medication prior to multi-level thoracolumbar spine surgery. MATERIAL AND METHODS: We retrospectively reviewed the medical records of 65 patients who underwent multi-level spine surgery from January 2009 to November 2014 at our institution. These patients were divided into two groups: the control group (n=45) did not take any anti-platelet medications prior to surgery; the anti-platelet group (n=20) discontinued the anti-platelet medication 7 days before the spine surgery...
October 14, 2016: Turkish Neurosurgery
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