TY  - CHAP
M1  - Book, Section
TI  - Chapter 71. Diagnosis & Management of Intraspinal, Epidural, &
                                                                Peripheral Nerve Hematoma
A1  - Jabri, Rasha S.
A1  - Deschner, Steven
A1  - Benzon, Honorio T.
A2  - Hadzic, Admir
Y1  - 2007
N1  - 
T2  - NYSORA Textbook of Regional Anesthesia and Acute Pain Management
AB  - Spinal  epidural  hematoma  (SEH)  is  an  accumulation  of  blood  in  the  potential  space  between  the  dura  and  the  bone.  Hemorrhage  into  the  spinal  canal  most  commonly  occurs  in  the  epidural  space  because  of  the  prominent  epidural  venous  plexus.  SEH  may  be  spontaneous  or  may  follow  minor  trauma,  such  as  lumbar  puncture  or  neuraxial  anesthesia.  It  is  more  likely  to  occur  in  anticoagulated  or  thrombocytopenic  patients,  or  in  those  with  liver  disease  or  alcoholism.  Approximately  one  quarter  to  one  third  of  all  cases  are  associated  with  anticoagulation  therapy.1,2  Spontaneous  bleeding  is  rare  but  may  be  seen  with  anticoagulation,  thrombolysis,  blood  dyscrasias,  coagulopathies,  thrombocytopenia,  neoplasms,  vascular  malformations,  or  vertebral  hemagioma.3,4  The  peridural  venous  plexus  is  usually  involved,  though  arterial  sources  of  hemorrhage  also  occur.5  SEHs  are  mostly  venous  in  nature  because  the  venous  plexus  lacks  valves,  and  the  plexus  has  been  shown  to  permit  a  reversal  in  blood  flow  during  pressure  increase  from  physical  activity.6  Hematoma  sites  are  usually  found  in  the  cervical  and  thoracic  spine.7  Most  SEHs  are  located  dorsal  to  the  dural  sac  because  of  the  firm  adherence  of  the  dural  sac  to  the  posterior  longitudinal  ligament  in  the  ventral  aspect  of  the  spinal  canal.  The  dorsal  aspect  of  the  thoracic  or  lumbar  region  is  involved  commonly,  and  expansion  is  limited  to  a  few  vertebral  levels.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=3508962
ER  -