Abstract
Spinal epidural hematomas are rare entities that can be associated with spinal traumatic injuries and vascular lesions or that can spontaneously arise. Several reports have linked these hematomas to heart valve surgery. We herein describe a 71-year-old female patient who developed postoperative paraplegia immediately after mitral valve repair. Magnetic resonance imaging revealed an epidural hematoma of the spinal cord from C7 to Th4. A laminectomy was not performed because the patient’s paraplegia gradually improved. After continuous rehabilitation, the patient regained sufficient muscle strength to perform standing exercises. She is presently capable of routine activities at home and is undergoing bethanechol chloride treatment for a neurogenic urinary bladder. Motor and sensory deficits of both lower limbs in a patient that arise immediately after heart surgery must be examined by early imaging to rule out space-occupying pathologies such as spinal epidural hematomas.
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Maingi N, Scully HE, Graham AF, Floras JS. Spontaneous spinal epidural hematoma in a patient with a mechanical aortic valve taking warfarin. Can J Cardiol 1995;11:429–432.
Parman SC. Spontaneous spinal epidural hematoma. Ann Emerg Med 1980;9:368–370.
Karakayali F, Basaran C, Soy A, Karakus S, Yabanoglu H, Moray G, et al. Spontaneous spleen rupture and rectus sheath hematoma in a patient with Kippel-Trenaunay syndrome: report of a case. Surg Today 2010;40(2):154–157.
Mustafa MH, Gallino R. Spontaneous spinal epidural hematoma causing cord compression after streptokinase and heparin therapy for acute coronary artery occlusion. South Med J 1988;81:1202–1203.
Wulf H. Epidural anaesthesia and spinal haematoma. Can J Anaesth 1996;43:1260–1271.
Major O, Sipos L, Czirjak B, Benoist G, Harvath M, Pasztor E. Spontaneous spinal epidural hematoma. Acta Neurochir (Wien) 1991;111:40–42.
Biglioli P, Roberto M, Cannata A, Parolari A, Spirito R. Paraplegia after iatrogenic extrinsic spinal cord compression after descending thoracic aorta repair: case report and literature review. J Thorac Cardiovasc Surg 2002;124:407–410.
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Hayashi, I., Shimamura, Y. & Maehara, M. Paraplegia due to spinal epidural hematoma after mitral valve surgery: Report of a case. Surg Today 41, 704–706 (2011). https://doi.org/10.1007/s00595-010-4315-z
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DOI: https://doi.org/10.1007/s00595-010-4315-z