Intraspinal Epidural Hematoma Caused By Acupuncture Mimicking An Intraspinal Synovial Cyst: A Case Report

Background Intraspinal hematoma is a rare complication of acupuncture. A few cases of subdural hematoma or epidural hematoma have been reported, with most of them in a fusiform shape, making the hematomas easy to identify on magnetic resonance imaging (MRI) scans. Case presentation A 49-year-old man presented with back pain that radiated into his lower limb that had appeared during acupuncture of his back. After admission, MRI was performed and indicated an L5/S1 intraspinal mass that had an oval shape, resembling an intraspinal cyst. The patient underwent surgery to remove the mass, which was confirmed to be a hematoma. Conclusion Intraspinal hematomas appear with various intensity signals and shapes on MRI, making its differential diagnosis difficult. A carefully medical history review (to determine if the pain derives from a puncture-type treatment or an injury) and surgical exploration may be helpful for identifying this condition.

Neurological deficit following spinal anaesthesia for caesarean section: an anesthetist’s nightmare

Neurological deterioration after regional anaesthesia, though extremely rare has been reported worldwide. A number of mechanisms like intraspinal hematoma, meningitis, cauda equina syndrome, etc. have been attributed to this dreadful complication. We present a case of a 26 year old female with no past medical history who was posted for emergency caesarean section. After an uneventful surgery under a subarachnoid block, the patient was discharged on the third day. However, on tenth postoperative day, the patient presented in casualty with bilateral lower limb weakness and backache. What was initially thought of being a rare post-operative complication of spinal anaesthesia was found to be an incidental intradural lesion on subsequent evaluation. Even a thorough pre-anaesthetic checkup may not prevent the occurrence of such incidents postoperatively.

Acute paraplegia in a puppy with hemophilia A

A seven-week-old, male chow chow-keeshond cross puppy was presented with acute paraplegia and episcleral hemorrhage. An X-linked, hereditary coagulopathy was suspected and confirmed by clotting factor analysis and necropsy findings of intraspinal hemorrhage. In young, male puppies with acute spinal pain and long-tract signs, intraspinal hematoma secondary to inherited X-linked coagulation factor deficiencies should be considered in the differential diagnosis.