A Case Report of a Subdural Hematoma Following Spinal Epidural Prior to a Total Knee Arthroplasty

Overview

Journal Case Rep Orthop

Publisher Wiley

Specialty Orthopedics

Date 2022 Jun 13

PMID 35692943

Authors

Brian J Carlson

David G Deckey

Henry D Clarke

Joshua S Bingham

Affiliations

Soon will be listed here.

Abstract

Introduction: This case report adds to current literature on management of a subdural hematoma following total knee arthroplasty and is particularly important as joint replacement moves into outpatient surgery centers where the orthopedic surgery team becomes the sole patient contact point. . A 66-year-old male presented to the emergency department five days after elective robotic-assisted left total knee arthroplasty performed with spinal epidural with the symptoms of a persistent nonpostural headache. CT of the head revealed a small bifrontal acute subdural hematoma. He was admitted for overnight monitoring as a precaution. No vascular abnormalities or underlying pathology was found on further advanced imaging. He was discharged the following morning after follow-up CT showed no focal changes. Magnetic resonance imaging (MRI) one month later confirmed resolution of the subdural hematoma.

Conclusion: Orthopedic surgeons should be aware of the signs and symptoms, as well as the risk factors for subdural hematomas following lumbar puncture, as it is a rare, but potentially life-threatening complication of spinal epidural.

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