Abstract
BackgroundIntrathecal injection is a rare complication of spinal anesthesia and an underreported complication of epidural blood patches. Although there are other reported cases of intrathecal blood injection, these cases lack confirmatory imaging and others report injection of mixed blood with other agents.Case presentationWe present a case report of post-laminectomy cerebrospinal fluid leak who underwent epidural blood patch placement. CT and MRI brain imaging was obtained, depicting intrathecal blood products. The patient had subsequent seizures and respiratory distress, received supportive care, and returned to baseline after several days.ConclusionThe patient’s clinical course illustrates the potential complications of blood products within CSF, including seizures and respiratory distress, which improved with supportive care in this case. Importantly, to our knowledge, this is the only report that clearly depicts injection of purely blood products, without other confounding agents (such as gadolinium), into intrathecal space and with diffuse spread through the CSF as visualized on CT and MRI imaging.
Highlights
Intrathecal injection is a rare complication of spinal anesthesia and an underreported complication of epidural blood patches
The patient’s clinical course illustrates the potential complications of blood products within cerebrospinal fluid (CSF), including seizures and respiratory distress, which improved with supportive care in this case
To our knowledge, this is the only report that clearly depicts injection of purely blood products, without other confounding agents, into intrathecal space and with diffuse spread through the CSF as visualized on Computed tomography (CT) and magnetic resonance imaging (MRI) imaging
Summary
The patient’s clinical course illustrates the potential complications of blood products within CSF, including seizures and respiratory distress, which improved with supportive care in this case.
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