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VOLUME 22 , ISSUE 7 ( 2018 ) > List of Articles

CASE REPORT

Epidural hematoma: Vigilance beyond guidelines

Nitin Bhorkar, Tasneem Dhansura, Urmila Tarawade, Sanket Mehta

Keywords : Anticoagulation, epidural catheter, epidural hematoma

Citation Information : Bhorkar N, Dhansura T, Tarawade U, Mehta S. Epidural hematoma: Vigilance beyond guidelines. Indian J Crit Care Med 2018; 22 (7):555-557.

DOI: 10.4103/ijccm.IJCCM_71_18

License: CC BY-ND 3.0

Published Online: 01-07-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Coagulopathy either from the use of anticoagulant, antiplatelet, or thrombolytic medications or from underlying medical conditions is considered one of the major risk factors for epidural hematoma formation related to epidural catheter placement or removal. The American Society of Regional Anesthesia and Pain Medicine (ASRA) has laid down guidelines regarding timing of neuraxial blockade or removal of neuraxial catheters in patients receiving either antithrombotic or thrombolytic therapy. We present a case of acute onset of paraplegia because of an epidural hematoma following removal of the epidural catheter in a patient who was given the first dose of antithrombotic therapy after the removal of the epidural catheter as per the ASRA guidelines. The epidural hematoma was diagnosed with an urgent magnetic resonance imaging, and the patient was urgently taken up for surgical evacuation of the hematoma. The patient made full recovery over 1 week period.


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