Spontaneous cervical spinal epidural haematoma in late pregnancy

Spontaneous cervical spinal epidural haematoma in late pregnancy

Published: 26 Jul 2018

© Anaesthesia Cases / 2018-0104 / ISSN 2396-8397

Authors

Dr Tony Wong [1]
Dr Adam Low [2]
  • [1] Senior Registrar, Anaesthetics, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
  • [2] Consultant, Anaesthetics, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom

Summary

Spontaneous spinal epidural haematoma (SSEH) is rare, especially in pregnancy, and may lead to permanent neurological damage. Presentation varies from altered sensation to paralysis depending on the location and severity of the haematoma. A multi-disciplinary approach is essential for effective management of such cases. A 39-week primigravida presented to a district general hospital with an acute cervical neurological deficit. She was transferred to a specialist centre for urgent magnetic resonance imaging followed by sequential caesarean section and cervical epidural haematoma evacuation. The combined procedures were uneventful with a healthy baby delivered and recovering maternal neurology. Co-ordinating multiple specialties from geographically separate sites created a number of peri-operative challenges. 

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