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REGIONAL ANESTHESIA

Epidural Hematoma After Spinal Anesthesia in a Patient with Undiagnosed Epidural Lymphoma

André Gottschalk, MD^*, Petra Bischoff, MD^*, Katrin Lamszus, MD, and Thomas Standl, MD^*

Departments of *Anesthesiology and Neurosurgery, University Hospital Hamburg-Eppendorf, Germany

Address correspondence to André Gottschalk, MD, Department of Anesthesiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. Address email to gottschalk.andre{at}gmx.de

The incidence of hemorrhagic complications after neuroaxial anesthesia is very infrequent. We report a case of a woman developing epidural bleeding 3 wk after performing an uneventful spinal anesthesia at the lumbar level L3-4 for removal of a wire loop in her left knee. No hemostasis altering medication had been taken before and after spinal puncture. The hematoma presenting at the lumbar level L2-3 had to be removed via laminectomy. Pathological examination of the hematoma revealed a highly vascularized centroblastic non-Hodgkin’s lymphoma that was not diagnosed before surgery. The patient did not develop any neurological deficits.

IMPLICATIONS: We report a case of a women developing epidural bleeding 3 wk after performing an uneventful spinal anesthesia for removal of a wire loop in her left knee. Pathological examination of the neurosurgically removed hematoma revealed a highly vascularized epidural centroblastic non-Hodgkin lymphoma.