Lumbar epidural hematoma following lumbar puncture: the role of high dose LMWH and late surgery. A case report
Hematoma lumbar epidural postpunción lumbar; influencia de dosis altas de LMWH y cirugía diferida
D. Gurkanlar
, C. Acikbas, G.K. Cengiz, R. Tuncer
Department of Neurosurgery. Akdeniz University. School of Medicine. Antalya. Türkiye
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Tuncer" "autores" => array:4 [ 0 => array:3 [ "nombre" => "D." "apellidos" => "Gurkanlar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Acikbas" ] 2 => array:2 [ "nombre" => "G.K." "apellidos" => "Cengiz" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Tuncer" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Department of Neurosurgery. Akdeniz University. School of Medicine. Antalya. Türkiye" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author: Yeşilbahçe Mahallesi. Portakal Çiçeği Antalya. Türkiye." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hematoma lumbar epidural postpunción lumbar; influencia de dosis altas de LMWH y cirugía diferida" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-06-26" "fechaAceptado" => "2006-04-26" "PalabrasClave" => array:2 [ "en" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec159544" "palabras" => array:5 [ 0 => "Lumbar" 1 => "Epidural hematoma" 2 => "Surgery" 3 => "LMWH" 4 => "Myelography" ] ] 1 => array:4 [ "clase" => "abr" "titulo" => "Abbreviations" "identificador" => "xpalclavsec159546" "palabras" => array:7 [ 0 => "CMT" 1 => "CT" 2 => "HBPM" 3 => "HEE" 4 => "LMWH" 5 => "MRI" 6 => "SEH" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec159545" "palabras" => array:5 [ 0 => "Lumbar" 1 => "Hematoma epidural" 2 => "Cirugía" 3 => "HBPS" 4 => "Mielografía" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Spinal epidural hematoma (SEH) is a known complication of spinal surgery, but the incidence of post-surgical SEHs that result in neurologic deficits is extremely rare (0.1%). Patients that require multilevel lumbar procedures and/or have a preoperative coagulopathy are at a significantly higher risk of developing an epidural hematoma. The introduction of higher dose of low molecular weight heparin (LMWH) twice daily 30<span class="elsevierStyleHsp" style=""></span>mg regimen) increased the reported incidence of neuroaxial hematomas. Surgery performed within 8 hours makes good or partial recovery of neurologic function.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Our patient was also started on higher dose of LMWH and developed neurological deficits due to a SEH following lumbar puncture. She underwent operation after six days and she had a mild recovery following the operation.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Current administration of high doses of LMWH can cause SEH even after a lumbar puncture, which was performed without multiple attempts.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Although surgery performed within 8 hours makes good or partial recovery of neurologic function, laminectomy and epidural hematoma evacuation performed after three days can also have successful results.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El hematoma espinal epidural (HEE) es una complicación conocida en la cirugía espinal, pero la incidencia del HEE que da lugar a déficit neurológico es muy rara (0,1%). Los pacientes que necesitan intervenciones en varios niveles lumbares y/o que tienen una coagulopatía preoperatoria tienen un riesgo significativamente mayor de desarrollar un hematoma epidural. La introducción de dosis altas de heparina de bajo peso molecular (HBPM), (30<span class="elsevierStyleHsp" style=""></span>mgrs. dos veces al día) aumentan la incidencia de hematomas neuroaxiales. La cirugía llevada a cabo dentro de las 8 horas da lugar a un recuperación buena o parcial de la función neurológica.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Nuestro paciente fue tratada con dosis altas de HBPM y desarrolló un déficit neurológico debido a un HEE, después de una punción lumbar. Fue operada al cabo de seis días y se recuperó parcialmente de su déficit después de la intervención.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La administración actual de dosis altas de HBPM puede dar lugar a HEE, incluso después de una punción lumbar, que se hizo en pocos intentos.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Aunque la cirugía realizada en las primeras 8 horas produce una recuperación buena o parcial, la laminectomía y evacuación del hematoma llevada a cabo después de tres días también puede dar lugar a buenos resultados.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Gurkanlar, D.; Acikbas, C.; Cengiz, G.K.; Tuncer, R.: Lumbar epidural hematoma following lumbar puncture: the role of HIGH dose lmwh and late surgery. A case report. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Julio | 0 | 1 | 1 |
| 2023 Marzo | 4 | 1 | 5 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 14 | 7 | 21 |
| 2018 Enero | 19 | 12 | 31 |
| 2017 Diciembre | 12 | 5 | 17 |
| 2017 Noviembre | 38 | 28 | 66 |
| 2017 Octubre | 8 | 10 | 18 |
| 2017 Septiembre | 13 | 7 | 20 |
| 2017 Agosto | 13 | 13 | 26 |
| 2017 Julio | 11 | 7 | 18 |
| 2017 Junio | 16 | 27 | 43 |
| 2017 Mayo | 19 | 18 | 37 |
| 2017 Abril | 16 | 15 | 31 |
| 2017 Marzo | 5 | 4 | 9 |
| 2017 Febrero | 7 | 4 | 11 |
| 2017 Enero | 8 | 3 | 11 |
| 2016 Diciembre | 42 | 11 | 53 |
| 2016 Noviembre | 58 | 6 | 64 |
| 2016 Octubre | 54 | 14 | 68 |
| 2016 Septiembre | 35 | 11 | 46 |
| 2016 Agosto | 0 | 13 | 13 |
| 2016 Julio | 0 | 10 | 10 |
| 2016 Marzo | 3 | 0 | 3 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Septiembre | 2 | 0 | 2 |
| 2015 Agosto | 2 | 0 | 2 |
| 2015 Julio | 2 | 0 | 2 |
| 2015 Junio | 11 | 8 | 19 |
| 2015 Mayo | 29 | 14 | 43 |
| 2015 Abril | 20 | 16 | 36 |
| 2015 Marzo | 16 | 12 | 28 |
| 2015 Febrero | 9 | 15 | 24 |
| 2015 Enero | 26 | 20 | 46 |
| 2014 Diciembre | 18 | 14 | 32 |
| 2014 Noviembre | 10 | 20 | 30 |
| 2014 Octubre | 14 | 22 | 36 |
| 2014 Septiembre | 15 | 22 | 37 |
| 2014 Agosto | 20 | 15 | 35 |
| 2014 Julio | 13 | 13 | 26 |
| 2014 Junio | 28 | 25 | 53 |
| 2014 Mayo | 22 | 17 | 39 |
| 2014 Abril | 18 | 10 | 28 |
| 2014 Marzo | 25 | 22 | 47 |
| 2014 Febrero | 19 | 22 | 41 |
| 2014 Enero | 17 | 9 | 26 |
| 2013 Diciembre | 14 | 20 | 34 |
| 2013 Noviembre | 20 | 20 | 40 |
| 2013 Octubre | 36 | 14 | 50 |
| 2013 Septiembre | 31 | 12 | 43 |
| 2013 Agosto | 33 | 24 | 57 |
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| 2013 Junio | 26 | 21 | 47 |
| 2013 Mayo | 30 | 23 | 53 |
| 2013 Abril | 22 | 14 | 36 |
| 2013 Marzo | 20 | 23 | 43 |
| 2013 Febrero | 24 | 14 | 38 |
| 2013 Enero | 24 | 18 | 42 |
| 2012 Diciembre | 24 | 23 | 47 |
| 2012 Noviembre | 1 | 9 | 10 |
| 2012 Septiembre | 0 | 2 | 2 |
| 2012 Enero | 7 | 0 | 7 |
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