1/6. Spinal haematoma following epidural anaesthesia in a patient with eclampsia.A patient with a twin pregnancy required a Caesarean section for severe pre-eclampsia. Her platelet count was 71 x 10(9).l-1. Epidural anaesthesia was performed after platelet transfusion. A spinal epidural haematoma was diagnosed postoperatively. A generalised tonic-clonic seizure sparing the lower limbs enabled early diagnosis to be made. The patient recovered with no permanent neurological damage after laminectomy and clot removal. The risks and benefits of regional techniques require careful consideration, and postoperative monitoring for recovery of neural blockade is essential.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/6. Spontaneous spinal epidural hematoma during pregnancy.A case of spontaneous spinal epidural hematoma during pregnancy is reported. The patient, three weeks before term, was operated upon successfully. A healthy child was delivered with forceps three days after the operation.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
3/6. Neonatal subgaleal hematoma causing brain compression: report of two cases and review of the literature.OBJECTIVE AND IMPORTANCE: Neonatal subgaleal hematomas (SGHs) are infrequent but underdiagnosed collections of blood beneath the galea, often caused by vacuum delivery. With massive bleeding into the subgaleal space, exsanguination and hypovolemic shock can cause death in 20 to 60% of newborn infants. We report the first two known patients with extracranial cerebral compression caused by SGH. Also, the surgical evacuation of neonatal SGH has not been described previously. CLINICAL PRESENTATION: One patient was a full-term boy who was delivered via vacuum extraction after an uncomplicated pregnancy. Within a few hours, he developed an expanding fluid collection of the scalp and disseminated intravascular coagulation and shock requiring intubation, inotropic support, and blood transfusions. His head circumference grew from 33 cm at birth to 42 cm. He became progressively lethargic and developed posturing movements. Computed tomography of the head revealed a massive SGH causing gross overlapping of the cranial sutures and diffuse cerebral edema. The other patient was a full-term boy delivered via cesarean section after an unsuccessful attempt at vacuum extraction and forceps delivery. The initial head circumference was 34 cm. Within a few hours, he developed an expanding fluid collection of the scalp and became progressively lethargic with posturing. magnetic resonance imaging of the head revealed a massive SGH with cranial compromise and diffuse cerebral edema. INTERVENTION: Both children had radiographic features indicative of elevated intracranial pressure as well as neurological decompensation. The first patient was taken to the operating room, and the hematoma was evacuated through a small scalp incision. Initially, approximately 150 ml of blood was removed, and a Jackson-Pratt drain diverted another 200 ml of blood during the next 2 days. The infant made a good recovery. In the second case, the patient remained too unstable for operative intervention and died. CONCLUSION: Extracranial cerebral compression represents another way by which neonatal SGH may jeopardize the infant's life. Management consists of measures to correct hypovolemic shock and disseminated intravascular coagulation, as well as surgical intervention to control elevated intracranial pressure.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
4/6. Spontaneous cervical epidural haematoma during pregnancy.Spontaneous cervical epidural haematoma is very rare during pregnancy. We describe a woman who presented with tetraplegia at 41 weeks of pregnancy. She had no previous history of any relevant medical disorder. Her upper level of anaesthesia was at the second thoracic segment. The condition was diagnosed by magnetic resonance imaging, and both caesarean section and decompression were conducted 12 hours after the event. The neurological deficit showed little recovery. histology was non-specific and follow-up magnetic resonance imaging showed spinal cord ischaemia. The prognosis in this condition depends on the interval of time between onset and decompression.- - - - - - - - - - ranking = 6keywords = pregnancy (Clic here for more details about this article) |
5/6. Case report: spontaneous spinal epidural haematoma during pregnancy: case report and review of the literature.Spontaneous epidural haematoma is rare in pregnancy and only five cases have been reported. We present a case of a 31-year-old female G2P1 who at 32 weeks of gestation developed progressive ascending paralysis and numbness to a level of approximately T4. An urgent MRI of the spine was performed, which demonstrated a posterior epidural lesion at T1-T4 level. The lesion showed signal changes consistent with an epidural haematoma in the hyperacute stage. An emergency cesarean section was performed followed by spinal decompression and removal of an epidural haematoma. The patient's neurological function subsequently improved. The diagnosis and management of spontaneous epidural haematoma in pregnancy is presented with a review of the literature.- - - - - - - - - - ranking = 6keywords = pregnancy (Clic here for more details about this article) |
6/6. Spontaneous spinal extradural hematoma during pregnancy.BACKGROUND: Spontaneous spinal hematomas are rare in pregnancy, and only two cases have previously been described. This report reviews other similar cases and discusses the aetiology and management of this condition in relation to pregnancy. CASE: A 26-year-old primigravida presented at 35 weeks of gestation with a history of sudden onset of back pain and weakness with loss of sensation of her legs. On examination there was tenderness over the seventh thoracic vertebra with loss of sensation below the level of the T7 dermatome and reduced power in both lower limbs. magnetic resonance imaging demonstrated an anterior extradural lesion in the mid-thoracic region of the spinal cord. An elective cesarean section was performed followed by a costotransversectomy and removal of an extradural hematoma. The patient's neurological function subsequently improved. CONCLUSION: Acute spontaneous spinal extradural hematoma occurring during pregnancy can be associated with successful outcome following prompt diagnosis and surgical treatment.- - - - - - - - - - ranking = 7keywords = pregnancy (Clic here for more details about this article) |