{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:33:15Z","timestamp":1769725995319,"version":"3.49.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"11","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,9,15]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spinal epidural block is widely used for pain control. While complications such as CSF leakage or epidural hematoma are occasionally reported, subdural hematoma (SDH) following an epidural block is rare. To the authors\u2019 knowledge, a hematoma involving both the subdural and epi-arachnoid spaces has not been previously reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 49-year-old man with a history of chronic back pain developed severe bilateral leg paresthesia 8 days after a routine lumbar epidural block. MRI revealed an SDH extending from T8 to S3, compressing the dorsal spinal canal. Surgical decompression was performed via hemilaminectomy at L2\u20133 and L5\u2013S1, followed by durotomy and irrigation with a Nelaton catheter. The patient had full symptomatic relief postoperatively and showed complete hematoma resolution within 3 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Although spinal epidural block is generally considered a safe procedure, rare complications such as SDH can occur. Physicians should maintain a high index of suspicion for such complications in patients presenting without new neurological symptoms after epidural block. When diagnosed with SDH, surgical treatment including laminectomy and irrigation via Nelaton catheter may be necessary to optimize patient outcomes.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25448\">https:\/\/thejns.org\/doi\/10.3171\/CASE25448<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25448","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:26:36Z","timestamp":1758587196000},"source":"Crossref","is-referenced-by-count":0,"title":["Subdural and epi-arachnoid hemorrhage following spinal epidural block requiring hematoma removal: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2723-9316","authenticated-orcid":true,"given":"Sang Youp","family":"Han","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"So Un","family":"Se","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae-Won","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Eun","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Choon-Keun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"7","key":"bib1","series-title":"Acta Anaesthesiol Scand","first-page":"858","article-title":"Major complications of epidural anesthesia: a prospective study of 5083 cases at a single hospital","volume":"58","author":"Kang","year":"2014","unstructured":"Kang XHBao FPXiong XXMajor complications of epidural anesthesia: a prospective study of 5083 cases at a single hospital. Acta Anaesthesiol Scand. 2014;58(7):858-866."},{"issue":"1","key":"bib2","series-title":"BMC Anesthesiol","first-page":"110","article-title":"Spinal subdural hematoma and subdural anesthesia following combined spinal\u2013epidural anesthesia: a case report","volume":"21","author":"Bi","year":"2021","unstructured":"Bi YZhou J.Spinal subdural hematoma and subdural anesthesia following combined spinal\u2013epidural anesthesia: a case report. BMC Anesthesiol. 2021;21(1):110."},{"issue":"4","key":"bib3","series-title":"Masui","first-page":"463","article-title":"Spinal subdural hematoma following spinal anesthesia in a patient without coagulation abnormalities","volume":"58","author":"Tobe","year":"2009","unstructured":"Tobe MSorimachi YTomioka ASaito S.Spinal subdural hematoma following spinal anesthesia in a patient without coagulation abnormalities. Masui. 2009;58(4):463-466."},{"issue":"23","key":"bib4","series-title":"Spine (Phila Pa 1976)","first-page":"E547","article-title":"Acute nontraumatic spinal subdural hematomas in three patients","volume":"26","author":"Morandi","year":"2001","unstructured":"Morandi XRiffaud LChabert EBrassier G.Acute nontraumatic spinal subdural hematomas in three patients. Spine (Phila Pa 1976). 2001;26(23):E547-E551."},{"issue":"5","key":"bib5","series-title":"Skelet Radiol","first-page":"477","article-title":"Spinal subdural hematoma","volume":"25","author":"Shimada","year":"1996","unstructured":"Shimada YSato KAbe EMiyakoshi NTsutsumi Y.Spinal subdural hematoma. Skelet Radiol. 1996;25(5):477-480."},{"issue":"3","key":"bib6","series-title":"Joint Bone Spine","first-page":"345","article-title":"Acute spontaneous spinal subdural hematoma in a patient with bilateral incarcerated inguinal hernia","volume":"75","author":"Ozdemir","year":"2008","unstructured":"Ozdemir OCalisaneller TYildirim ECaner HAltinors N.Acute spontaneous spinal subdural hematoma in a patient with bilateral incarcerated inguinal hernia. Joint Bone Spine. 2008;75(3):345-347."},{"issue":"2","key":"bib7","series-title":"Asian J Neurosurg","first-page":"347","article-title":"Spinal subdural hematoma following epidural anesthesia","volume":"18","author":"Bhosle","year":"2023","unstructured":"Bhosle RRaju DPatel SSSpinal subdural hematoma following epidural anesthesia. Asian J Neurosurg. 2023;18(2):347-351."},{"key":"bib8","series-title":"Int J Obstet Anesth","first-page":"58","article-title":"Intracranial subdural haematoma following neuraxial anaesthesia in the obstetric population: a literature review with analysis of 56 reported cases","volume":"25","year":"2016","unstructured":"CuypersVVan de VeldeMDevroeS. Intracranial subdural haematoma following neuraxial anaesthesia in the obstetric population: a literature review with analysis of 56 reported cases. Int J Obstet Anesth. 2016;25:58\u201165."},{"issue":"5","key":"bib9","series-title":"J Korean Neurosurg Soc","first-page":"483","article-title":"Acute cervical subdural hematoma with quadriparesis after cervical transforaminal epidural block","volume":"58","author":"Lee","year":"2015","unstructured":"Lee JKChae KWJu CIKim BW.Acute cervical subdural hematoma with quadriparesis after cervical transforaminal epidural block. J Korean Neurosurg Soc. 2015;58(5):483-486."},{"issue":"6","key":"bib10","series-title":"Spine","first-page":"E174","article-title":"Subdural hematoma after cervical epidural steroid injection","volume":"27","author":"Reitman","year":"2002","unstructured":"Reitman CAWatters WC.Subdural hematoma after cervical epidural steroid injection. Spine. 2002;27(6):E174-E176."},{"issue":"4","key":"bib11","series-title":"Asian J Neurosurg","first-page":"224","article-title":"Spinal subdural hematoma following epidural anesthesia","volume":"9","author":"Ji","year":"2014","unstructured":"Ji WZhang MLiu HSpinal subdural hematoma following epidural anesthesia. Asian J Neurosurg. 2014;9(4):224-226."},{"issue":"7","key":"bib1","series-title":"Acta Anaesthesiol Scand","first-page":"858","article-title":"Major complications of epidural anesthesia: a prospective study of 5083 cases at a single hospital","volume":"58","author":"Kang","year":"2014","unstructured":"Kang XHBao FPXiong XXMajor complications of epidural anesthesia: a prospective study of 5083 cases at a single hospital. Acta Anaesthesiol Scand. 2014;58(7):858-866."},{"issue":"1","key":"bib2","series-title":"BMC Anesthesiol","first-page":"110","article-title":"Spinal subdural hematoma and subdural anesthesia following combined spinal\u2013epidural anesthesia: a case report","volume":"21","author":"Bi","year":"2021","unstructured":"Bi YZhou J.Spinal subdural hematoma and subdural anesthesia following combined spinal\u2013epidural anesthesia: a case report. BMC Anesthesiol. 2021;21(1):110."},{"issue":"4","key":"bib3","series-title":"Masui","first-page":"463","article-title":"Spinal subdural hematoma following spinal anesthesia in a patient without coagulation abnormalities","volume":"58","author":"Tobe","year":"2009","unstructured":"Tobe MSorimachi YTomioka ASaito S.Spinal subdural hematoma following spinal anesthesia in a patient without coagulation abnormalities. Masui. 2009;58(4):463-466."},{"issue":"23","key":"bib4","series-title":"Spine (Phila Pa 1976)","first-page":"E547","article-title":"Acute nontraumatic spinal subdural hematomas in three patients","volume":"26","author":"Morandi","year":"2001","unstructured":"Morandi XRiffaud LChabert EBrassier G.Acute nontraumatic spinal subdural hematomas in three patients. Spine (Phila Pa 1976). 2001;26(23):E547-E551."},{"issue":"5","key":"bib5","series-title":"Skelet Radiol","first-page":"477","article-title":"Spinal subdural hematoma","volume":"25","author":"Shimada","year":"1996","unstructured":"Shimada YSato KAbe EMiyakoshi NTsutsumi Y.Spinal subdural hematoma. Skelet Radiol. 1996;25(5):477-480."},{"issue":"3","key":"bib6","series-title":"Joint Bone Spine","first-page":"345","article-title":"Acute spontaneous spinal subdural hematoma in a patient with bilateral incarcerated inguinal hernia","volume":"75","author":"Ozdemir","year":"2008","unstructured":"Ozdemir OCalisaneller TYildirim ECaner HAltinors N.Acute spontaneous spinal subdural hematoma in a patient with bilateral incarcerated inguinal hernia. Joint Bone Spine. 2008;75(3):345-347."},{"issue":"2","key":"bib7","series-title":"Asian J Neurosurg","first-page":"347","article-title":"Spinal subdural hematoma following epidural anesthesia","volume":"18","author":"Bhosle","year":"2023","unstructured":"Bhosle RRaju DPatel SSSpinal subdural hematoma following epidural anesthesia. Asian J Neurosurg. 2023;18(2):347-351."},{"key":"bib8","series-title":"Int J Obstet Anesth","first-page":"58","article-title":"Intracranial subdural haematoma following neuraxial anaesthesia in the obstetric population: a literature review with analysis of 56 reported cases","volume":"25","year":"2016","unstructured":"CuypersVVan de VeldeMDevroeS. Intracranial subdural haematoma following neuraxial anaesthesia in the obstetric population: a literature review with analysis of 56 reported cases. Int J Obstet Anesth. 2016;25:58\u201165."},{"issue":"5","key":"bib9","series-title":"J Korean Neurosurg Soc","first-page":"483","article-title":"Acute cervical subdural hematoma with quadriparesis after cervical transforaminal epidural block","volume":"58","author":"Lee","year":"2015","unstructured":"Lee JKChae KWJu CIKim BW.Acute cervical subdural hematoma with quadriparesis after cervical transforaminal epidural block. J Korean Neurosurg Soc. 2015;58(5):483-486."},{"issue":"6","key":"bib10","series-title":"Spine","first-page":"E174","article-title":"Subdural hematoma after cervical epidural steroid injection","volume":"27","author":"Reitman","year":"2002","unstructured":"Reitman CAWatters WC.Subdural hematoma after cervical epidural steroid injection. Spine. 2002;27(6):E174-E176."},{"issue":"4","key":"bib11","series-title":"Asian J Neurosurg","first-page":"224","article-title":"Spinal subdural hematoma following epidural anesthesia","volume":"9","author":"Ji","year":"2014","unstructured":"Ji WZhang MLiu HSpinal subdural hematoma following epidural anesthesia. Asian J Neurosurg. 2014;9(4):224-226."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/11\/article-CASE25448.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/11\/article-CASE25448.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/11\/article-CASE25448.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:09:23Z","timestamp":1769684963000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/11\/article-CASE25448.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":22,"journal-issue":{"issue":"11"},"URL":"https:\/\/doi.org\/10.3171\/case25448","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,15]]}}}