Spontaneous spinal epidural hematoma presenting as paraplegia after cardiac surgery

An 86-year-old woman was scheduled to undergo aortic valve replacement and coronary artery bypass graft. On postoperative day 3, she developed sudden-onset neck pain followed by weakness in the right arm. Her symptoms worsened with time, and she developed paraplegia. At 60 h after the first complain...

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2016-03, Vol.64 (3), p.153-155
Main Authors: Kin, Hajime, Mukaida, Masayuki, Koizumi, Junichi, Kamada, Takeshi, Mitsunaga, Yoshino, Iwase, Tomoyuki, Ikai, Akio, Okabayashi, Hitoshi
Format: Article
Language:English
Subjects:
Aged, 80 and over
Anticoagulants
Back pain
Blood pressure
Cardiac Surgery
Cardiac Surgical Procedures - adverse effects
Cardiology
Case Report
Case reports
Coronary Artery Bypass - adverse effects
Coronary vessels
Diagnosis, Differential
Epidural
Female
Heart surgery
Hematoma
Hematoma, Epidural, Spinal - complications
Hematoma, Epidural, Spinal - diagnosis
Hemodialysis
Humans
Hypertension
Intensive care
Magnetic Resonance Imaging - methods
Medical imaging
Medicine
Medicine & Public Health
Neck pain
Paralysis
Paraplegia - diagnosis
Paraplegia - etiology
Patients
Spinal cord
Stroke
Surgical Oncology
Thoracic Surgery
Tomography, X-Ray Computed
Veins & arteries
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Description
Summary:An 86-year-old woman was scheduled to undergo aortic valve replacement and coronary artery bypass graft. On postoperative day 3, she developed sudden-onset neck pain followed by weakness in the right arm. Her symptoms worsened with time, and she developed paraplegia. At 60 h after the first complaint, spontaneous spinal epidural hematoma (SSEH) from C2 to C6 with spinal cord compression was diagnosed from a magnetic resonance image of the cervical region. We decided on conservative therapy because operative recovery was impossible. Delayed diagnosis led to grievous results in the present case. When neurological abnormalities follow neck or back pain after open heart surgery, SSEH must be considered in the differential diagnosis. Further, if it is suspected, early cervical computed tomography/magnetic resonance imaging and surgery should be considered.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-014-0401-2