J Korean Neurosurg Soc.  2015 Nov;58(5):483-486. 10.3340/jkns.2015.58.5.483.

Acute Cervical Subdural Hematoma with Quadriparesis after Cervical Transforaminal Epidural Block

• Lee JK
• Chae KW
• Ju CI
• Kim BW

• KMID: 2191417
• DOI: http://doi.org/10.3340/jkns.2015.58.5.483

Abstract

Cervical epidural steroid injection is frequently used in the conservative management of neck pain and cervical radiculopathy. Epidural cervical transforaminal injections are usually well-tolerated with mild side effects such as transient decreased sensory and motor function, or headache due to dural puncture. Although there are a few case reports about adverse effects of cervical epidural injection in the literature, it can cause severe complications such as large hematoma, infarction by spinal vascular injury. Subdural hematoma has been occurred much less common rather than epidural hematoma in the spinal cord. We report a rare catastrophic case of cervical spinal subdural hematoma with quadriparesis after cervical transforaminal epidural block.

Keyword

Subdural spinal hematoma; Cervical transforaminal epidural block; Quadriparesis

MeSH Terms

Headache
Hematoma
Hematoma, Subdural*
Hematoma, Subdural, Spinal
Infarction
Injections, Epidural
Neck Pain
Punctures
Quadriplegia*
Radiculopathy
Spinal Cord
Vascular System Injuries

Figure

• 

  Fig. 1 A : Preoperative sagittal T2 weighted MR image shows the mottled mixed signal intensity nodular lesions in right side of intradural and extramedullary space at the level from medulla and cerebellum to C7 level. B and C : Axial T2 weighted MR images show high signal intensity of spinal cord with bulging contour that means spinal cord injury.

• 

  Fig. 2 A : Intraoperative microscopic view shows subdural hematoma in the intradural space and spinal cord was compressed by large amount of subdural hematoma. B : Postoperative T2-weighted sagittal MR image shows subdural hematoma was removed and the contour of spinal cord appears evidently.

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