Intrathecal hematoma and sacral radiculitis following repeat epidural blood patch

• 作 者: Jeremy Wolfson John Liaghat Hong Liu Cristina Chandler
• 机 构: Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, C
• 出 处: 生物医学研究杂志（英文版）
• 发表日期: 2021年1期
• 关键词: postdural puncture headache epidural blood patch intrathecal hematoma sacral rad

Postdural puncture headache (PDPH) is an incapacitating complication that can occur following spinal anesthesia and with inadvertent dural puncture during epidural anesthesia.We present a case of a 32-year-old G2P1 female who was admitted for induction of labor and received epidural catheter placement for analgesia.After an inadvertent dural puncture and development of a PDPH,the patient was offered conservative measures for the first 48 hours without improvement.An epidural blood patch (EBP) was placed achieving only moderate relief.Two days later,a second EBP was performed and the patient developed severe back pain which radiated bilaterally to her buttocks.Magnetic resonance imaging (MRI) demonstrated the presence of blood in the intrathecal space.This could be the cause of sacral radiculitis,an uncommon complication of an EBP.This suggests that EBPs could potentially cause neurologic symptoms which may be more common than people previously thought.As complicated outcomes have followed both conservative and aggressive management,MRI can be an early diagnostic tool in such cases and a multidisciplinary approach should be taken.