Literature review of spinal hematoma case reports: causes and outcomes in pediatric, obstetric, neuraxial and pain medicine cases
Authors' conclusion
Our data show a preponderance of spontaneous SEH in all patient populations. SEH developed even though the ASRA guidelines were followed, especially in patients on multiple anticoagulants. Patients with less impairment prior to surgery had a higher likelihood of complete recovery, regardless of the interval between surgery and onset of symptoms.
Study context
- Population
- Pediatric, adult and obstetric (OB) cases of spinal epidural hematoma (SEH), PubMed and Embase, English literature 1954 to July 2022
- Participants
- 940 cases
Main finding
As reported in the abstract
- Pediatric SEH typically spontaneous, related to coagulopathy or athletic trauma
- OB SEH spontaneous or related to neuraxial injections
- Adults on anticoagulant(s): SEH mostly spontaneous with no related etiology or related to neuraxial procedure
- SEH occurred despite adherence to the American Society of Regional Anesthesia (ASRA) guidelines
- Non-OB adults not on anticoagulants: SEH due to trauma, neuraxial injections, surgery or other causes
- Neurological recovery related to degree of neurological deficit before surgery
Original publication
Literature review of spinal hematoma case reports: causes and outcomes in pediatric, obstetric, neuraxial and pain medicine cases. Reg Anesth Pain Med. Published 23 January 2024. doi:10.
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