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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Spinal epidural hematoma &#40;SEH&#41; is a known complication of spinal surgery&#44; but the incidence of post-surgical SEHs that result in neurologic deficits is extremely rare &#40;0&#46;1&#37;&#41;&#46; Patients that require multilevel lumbar procedures and&#47;or have a preoperative coagulopathy are at a significantly higher risk of developing an epidural hematoma&#46; The introduction of higher dose of low molecular weight heparin &#40;LMWH&#41; twice daily 30<span class="elsevierStyleHsp" style=""></span>mg regimen&#41; increased the reported incidence of neuroaxial hematomas&#46; Surgery performed within 8 hours makes good or partial recovery of neurologic function&#46;</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&#46; She underwent operation after six days and she had a mild recovery following the operation&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Current administration of high doses of LMWH can cause SEH even after a lumbar puncture&#44; which was performed without multiple attempts&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Although surgery performed within 8 hours makes good or partial recovery of neurologic function&#44; laminectomy and epidural hematoma evacuation performed after three days can also have successful results&#46;</p>"
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        "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El hematoma espinal epidural &#40;HEE&#41; es una complicaci&#243;n conocida en la cirug&#237;a espinal&#44; pero la incidencia del HEE que da lugar a d&#233;ficit neurol&#243;gico es muy rara &#40;0&#44;1&#37;&#41;&#46; Los pacientes que necesitan intervenciones en varios niveles lumbares y&#47;o que tienen una coagulopat&#237;a preoperatoria tienen un riesgo significativamente mayor de desarrollar un hematoma epidural&#46; La introducci&#243;n de dosis altas de heparina de bajo peso molecular &#40;HBPM&#41;&#44; &#40;30<span class="elsevierStyleHsp" style=""></span>mgrs&#46; dos veces al d&#237;a&#41; aumentan la incidencia de hematomas neuroaxiales&#46; La cirug&#237;a llevada a cabo dentro de las 8 horas da lugar a un recuperaci&#243;n buena o parcial de la funci&#243;n neurol&#243;gica&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Nuestro paciente fue tratada con dosis altas de HBPM y desarroll&#243; un d&#233;ficit neurol&#243;gico debido a un HEE&#44; despu&#233;s de una punci&#243;n lumbar&#46; Fue operada al cabo de seis d&#237;as y se recuper&#243; parcialmente de su d&#233;ficit despu&#233;s de la intervenci&#243;n&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La administraci&#243;n actual de dosis altas de HBPM puede dar lugar a HEE&#44; incluso despu&#233;s de una punci&#243;n lumbar&#44; que se hizo en pocos intentos&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Aunque la cirug&#237;a realizada en las primeras 8 horas produce una recuperaci&#243;n buena o parcial&#44; la laminectom&#237;a y evacuaci&#243;n del hematoma llevada a cabo despu&#233;s de tres d&#237;as tambi&#233;n puede dar lugar a buenos resultados&#46;</p>"
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                    0 => array:2 [
                      "titulo" => "Fatal spontaneous spinal epidural hematoma following thrombolysis for myocardial infarction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;E&#46; Cohen"
                            1 => "H&#46;J&#46; Ginsberg"
                            2 => "D&#46; Emery"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "1998"
                        "volumen" => "49"
                        "paginaInicial" => "520"
                        "paginaFinal" => "522"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9586930"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous spinal epidural hematoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;W&#46; Cooper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1967.26.3.0343"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1967"
                        "volumen" => "26"
                        "paginaInicial" => "343"
                        "paginaFinal" => "345"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6019741"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib3"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathophysiology of spinal cord injury&#58; recovery after immediate and delayed decompression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;B&#46; Delamarter"
                            1 => "J&#46; Sherman"
                            2 => "J&#46;B&#46; Carr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Joint Surg Am"
                        "fecha" => "1995"
                        "volumen" => "77"
                        "paginaInicial" => "1042"
                        "paginaFinal" => "1049"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7608226"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                    0 => array:2 [
                      "titulo" => "The spontaneous spinal epidural hematoma&#46; A study of aetiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;J&#46;M&#46; Groen"
                            1 => "H&#46; Ponssen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Sci"
                        "fecha" => "1990"
                        "volumen" => "98"
                        "paginaInicial" => "121"
                        "paginaFinal" => "138"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2243224"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low molecular weight heparin and neuroaxial anesthesia"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46;T&#46; Horlocker"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Thrombosis Res"
                        "fecha" => "2001"
                        "volumen" => "101"
                        "paginaInicial" => "141"
                        "paginaFinal" => "154"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib6"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuroaxial blockade and low molecular weight heparin&#46; Balancing preoperative analgesia and thromboprophylaxis"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:2 [
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                            1 => "D&#46;J&#46; Wedel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Reg Anesth"
                        "fecha" => "1998"
                        "volumen" => "23"
                        "paginaInicial" => "164"
                        "paginaFinal" => "177"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preoperative antiplatelet therapy does not increase the risk of spinal hematoma associated with regional anesthesia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;T&#46; Horlocker"
                            1 => "D&#46;J&#46; Wedel"
                            2 => "D&#46;R&#46; Schroeder"
                            3 => "S&#46;H&#46; Rose"
                            4 => "B&#46;A&#46; Elliot"
                            5 => "D&#46;G&#46; McGregor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "1995"
                        "volumen" => "80"
                        "paginaInicial" => "303"
                        "paginaFinal" => "309"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7818117"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "referencia" => array:1 [
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paraplegia after lumbosacral nerve root block&#58; report of three cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
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                            1 => "T&#46;J&#46; Ericco"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "The Spine Journal"
                        "fecha" => "2002"
                        "volumen" => "2"
                        "paginaInicial" => "70"
                        "paginaFinal" => "75"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14588291"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The management of acute spinal cord compression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;A&#46; Johnston"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "1993"
                        "volumen" => "56"
                        "paginaInicial" => "1046"
                        "paginaFinal" => "1054"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8410001"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The regional anesthesia &#8216;learning curve&#8217;&#58; what is the minimum number of epidural and spinal blocks to reach consistency&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;J&#46; Kopacz"
                            1 => "J&#46;M&#46; Neal"
                            2 => "J&#46;E&#46; Pollock"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Reg Anesth"
                        "fecha" => "1996"
                        "volumen" => "21"
                        "paginaInicial" => "182"
                        "paginaFinal" => "190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8744658"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for spinal epidural hematoma after spinal surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Kou"
                            1 => "J&#46; Fischgrund"
                            2 => "A&#46; Biddinger"
                            3 => "H&#46; Herkowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Spine"
                        "fecha" => "2002"
                        "volumen" => "27"
                        "paginaInicial" => "1670"
                        "paginaFinal" => "1673"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12163731"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal epidural hematoma causing cord compression after tissue plasminogen activator and heparin therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;A&#46; Krolick"
                            1 => "G&#46;B&#46; Cintron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "South Med J"
                        "fecha" => "1991"
                        "volumen" => "84"
                        "paginaInicial" => "670"
                        "paginaFinal" => "671"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1903560"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal epidural hematoma after lumbar puncture in liver disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;G&#46; Laglia"
                            1 => "R&#46;L&#46; Eisenberg"
                            2 => "P&#46;R&#46; Weinstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1978"
                        "volumen" => "88"
                        "paginaInicial" => "515"
                        "paginaFinal" => "516"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/637434"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical management of spinal epidural hematoma&#58; relationship between surgical timing and neurological outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;T&#46; Lawton"
                            1 => "R&#46;W&#46; Porter"
                            2 => "J&#46;E&#46; Heiserman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1995.83.1.0001"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1995"
                        "volumen" => "83"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7782824"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic spontaneous spinal epidural haematoma simulating a lumbar stenosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46; Lunardi"
                            1 => "L&#46; Mastronardi"
                            2 => "F&#46; Lo Bianco"
                            3 => "G&#46; Schettini"
                            4 => "F&#46; Puzzilli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Spine J"
                        "fecha" => "1995"
                        "volumen" => "4"
                        "paginaInicial" => "64"
                        "paginaFinal" => "66"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7749912"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complications of laminectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46;H&#46; Mayfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Neurosurg"
                        "fecha" => "1976"
                        "volumen" => "23"
                        "paginaInicial" => "435"
                        "paginaFinal" => "439"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/975694"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal epidural hematoma in a patient with lupus coagulopathy&#58; MR findings"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46;R&#46; Mohazab"
                            1 => "B&#46; Langer"
                            2 => "D&#46; Spigos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.160.4.8456680"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR"
                        "fecha" => "1993"
                        "volumen" => "160"
                        "paginaInicial" => "853"
                        "paginaFinal" => "854"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8456680"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal epidural hematoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46;L&#46; Pear"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "AJR"
                        "fecha" => "1972"
                        "volumen" => "115"
                        "paginaInicial" => "155"
                        "paginaFinal" => "164"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thoracic epidural anesthesia and epidural hematoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Persson"
                            1 => "P&#46; Flisberg"
                            2 => "J&#46; Lundberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Anesthesiol Scand"
                        "fecha" => "2002"
                        "volumen" => "46"
                        "paginaInicial" => "1171"
                        "paginaFinal" => "1174"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unusual hematomas outside the spinal cord"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46;T&#46; Schwartz"
                            1 => "M&#46;A&#46; Sartavi"
                            2 => "J&#46;L&#46; Fox"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1973.39.2.0249"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1973"
                        "volumen" => "39"
                        "paginaInicial" => "249"
                        "paginaFinal" => "251"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4719702"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ligamentum flavum hematoma&#46; Report of two cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46;A&#46; Sweasey"
                            1 => "H&#46;C&#46; Coester"
                            2 => "H&#46; Rawal"
                            3 => "M&#46; Blaivas"
                            4 => "J&#46;E&#46; Mcgillicuddy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1992.76.3.0534"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1992"
                        "volumen" => "76"
                        "paginaInicial" => "534"
                        "paginaFinal" => "537"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1738036"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extensive application of epidural anesthesia and analgesia in a University hospital&#58; Incidence of complications related to technique"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Tanaka"
                            1 => "R&#46; Watanabe"
                            2 => "T&#46; Harada"
                            3 => "K&#46; Dan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Reg Anesth"
                        "fecha" => "1993"
                        "volumen" => "18"
                        "paginaInicial" => "34"
                        "paginaFinal" => "38"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8448096"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anticoagulants and spinal-epidural anesthesia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;P&#46; Vandermeulen"
                            1 => "H&#46;V&#46; Aken"
                            2 => "J&#46; Vermylen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "1994"
                        "volumen" => "79"
                        "paginaInicial" => "1165"
                        "paginaFinal" => "1177"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7978443"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
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Vol. 18. Núm. 1.
Páginas 52-55 (enero 2007)
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Vol. 18. Núm. 1.
Páginas 52-55 (enero 2007)
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
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1876
D. Gurkanlar
, C. Acikbas, G.K. Cengiz, R. Tuncer
Department of Neurosurgery. Akdeniz University. School of Medicine. Antalya. Türkiye
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Summary

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 30mg regimen) increased the reported incidence of neuroaxial hematomas. Surgery performed within 8 hours makes good or partial recovery of neurologic function.

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.

Current administration of high doses of LMWH can cause SEH even after a lumbar puncture, which was performed without multiple attempts.

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.

Key words:
Lumbar
Epidural hematoma
Surgery
LMWH
Myelography
Abbreviations:
CMT
CT
HBPM
HEE
LMWH
MRI
SEH
Resumen

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), (30mgrs. 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.

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.

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.

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.

Palabras clave:
Lumbar
Hematoma epidural
Cirugía
HBPS
Mielografía

Artículo

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