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Good outcomes after the delayed removal of an epidural hematoma: A case report.

Abstract Epidural hematomas can develop following intrathecal puncture, spinal vascular malformation, or spontaneous hemorrhage. Prompt recognition of symptoms and referral to neurosurgical services are crucial for recovery. We report a rare case of delayed removal of an epidural hematoma that resulted in good patient outcomes.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29620662
OWN - NLM
STAT- MEDLINE
DCOM- 20180416
LR  - 20180416
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 14
DP  - 2018 Apr
TI  - Good outcomes after the delayed removal of an epidural hematoma: A case report.
PG  - e0341
LID - 10.1097/MD.0000000000010341 [doi]
AB  - RATIONALE: Epidural hematomas can develop following intrathecal puncture, spinal 
      vascular malformation, or spontaneous hemorrhage. Prompt recognition of symptoms 
      and referral to neurosurgical services are crucial for recovery. We report a rare
      case of delayed removal of an epidural hematoma that resulted in good patient
      outcomes. PATIENT CONCERNS: A 69-year-old woman weighing 58 kg presented with
      back pain that had persisted for 12 years. Her medical history was notable for
      hypertension. Cervical computed tomography angiography indicated a giant
      abdominal aortic aneurysm measuring 11.58 x 17.34 x 13.00 cm in her abdominal
      cavity. Stent graft implantation was scheduled by the interventional therapy
      group to treat her abdominal aortic aneurysm under single-dose spinal anesthesia.
      Postoperatively, the patient complained of numbness and swelling of her lower
      extremities, with progressive paralysis developing in both legs accompanied with 
      sensory disturbances. DIAGNOSES: Delayed magnetic resonance imaging detected an
      epidural hematoma. INTERVENTIONS: Eighty hours after the onset of sensorimotor
      symptoms, lumbar decompression and removal of the hematoma were performed via
      laminectomy under general anesthesia. OUTCOMES: The patient was discharged 2
      months after the operation with a 3/5 score on the Muscle Strength Grading
      System. LESSONS: Laminectomy may be effective in achieving a good prognosis
      despite a considerable delay in diagnosis.
FAU - Yao, Yong-Xing
AU  - Yao YX
FAU - Li, Ming-Xia
AU  - Li MX
FAU - Sun, Lian-Juan
AU  - Sun LJ
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Anesthesia, Spinal/*adverse effects
MH  - Delayed Diagnosis
MH  - Female
MH  - Hematoma, Epidural, Spinal/chemically induced/diagnosis/*surgery
MH  - Humans
MH  - Laminectomy/*methods
MH  - Lumbar Vertebrae/surgery
MH  - Paralysis/chemically induced/surgery
MH  - Time-to-Treatment
EDAT- 2018/04/06 06:00
MHDA- 2018/04/17 06:00
CRDT- 2018/04/06 06:00
PHST- 2018/04/06 06:00 [entrez]
PHST- 2018/04/06 06:00 [pubmed]
PHST- 2018/04/17 06:00 [medline]
AID - 10.1097/MD.0000000000010341 [doi]
AID - 00005792-201804060-00040 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(14):e0341. doi: 10.1097/MD.0000000000010341.