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Journal of Medical Case Reports
Published in: Journal of Medical Case Reports 1/2017

Open Access 01-12-2017 | Case report

Anesthetic management of spontaneous cervical epidural hematoma during pregnancy: a case report

Authors: Mehdi Samali, Abdelghafour Elkoundi, Achraf Tahri, Mustapha Bensghir, Charki Haimeur

Published in: Journal of Medical Case Reports | Issue 1/2017

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Abstract

Background

Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression. Anesthetic management should also include measures to maintain the mean arterial pressure to improve spinal cord perfusion. Furthermore, spine surgery in pregnant patients needs special consideration in terms of positioning and in the postoperative period.

Case presentation

We present a case of a 35-year-old white woman at 21 weeks of gestation with a spontaneous cervical epidural hematoma. Fiberoptic bronchoscope-guided nasal intubation was a safe option to ensure a higher rate of successful endotracheal intubation while minimizing the risk of aggravating the injury. Her care posed other multiples challenges that required a multidisciplinary team approach.

Conclusions

The case of our patient serves as a reminder of this rare condition and its implications regarding anesthesia.
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Metadata
Title
Anesthetic management of spontaneous cervical epidural hematoma during pregnancy: a case report
Authors
Mehdi Samali
Abdelghafour Elkoundi
Achraf Tahri
Mustapha Bensghir
Charki Haimeur
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2017
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-017-1335-y

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