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34 Subarachnoid hematoma after attempted spinal block
  1. RF Santos,
  2. RL Silva,
  3. A Gomes,
  4. N Ribeiro and
  5. F Moura
  1. Centro Hospitalar Tâmega e Sousa, Guilhufe, Penafiel, Portugal


Background and Aims Subarachnoid hematoma is a rare but potentially serious complication of a subarachnoid block. Its occurrence is associated with several risk factors such as multiple spinal attempts, traumatic puncture and concurrent therapy with anticoagulants and/or antiplatelet agents.1

Methods Description of a case report in the section below.

Results Case Report: A healthy pregnant woman was admitted for an elective c-section under subarachnoid spinal block. After two hematic punctures at different lumbar levels, it was decided to proceed with a general anaesthesia instead. Surgery was performed with no reports of complications. About 7 days later, the patient reported neurologic symptoms and a spinal hematoma was diagnosed (figure 1 and 2). After consultation with a neurosurgical team, a conservative approach was decided upon. The patient was admitted to the hospital for close monitoring of neurological signs and throughout the 12 days of in-hospital stay, there was a spontaneous remission of symptoms as well as a significant reduction in the size of the hematoma, confirmed by magnetic resonance imaging. The patient was discharged home assymptomatic.

Abstract 34 Figure 1

Dorsolumbar MRI, T2 axial section image of dorsolumbar subarachnoid hematoma with a maximum width of 9 mm

Abstract 34 Figure 2

Dorsolumbar MRI, sagittal section image

Conclusions Although the recommended treatment for a subarachnoid hematoma is an emergent surgical decompression, there have been reports of small subarachnoid hematomas associated with mild pain complaints that are conservatively managed with satisfactory results.2

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