Acute cerebral infarction in a patient with an epidural catheter after left upper lobectomy: a case report View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-12

AUTHORS

Asuka Kitajima, Yuji Otsuka, Alan Kawarai Lefor, Masamitsu Sanui

ABSTRACT

BACKGROUND: There are several recent reports that left upper lobe lung resection is a risk factor for the development of postoperative thromboembolism. Although administering epidural analgesia is common in thoracic surgery, anesthesiologists should be alert when administering epidural analgesia to a patient undergoing left upper lobectomy, considering the increased risk of postoperative thromboembolism and the potential need for anticoagulation or fibrinolytic therapy in the immediate postoperative period. CASE PRESENTATION: A seventy-one-year-old female with a metastatic lung lesion developed a cerebral infarction approximately 30 h after video-assisted thoracoscopic left upper lobectomy. Cerebral intravascular therapy was indicated and the epidural catheter was removed immediately to avoid formation of an epidural hematoma. Approximately four hours after onset, reperfusion was successfully established by aspiration of endovascular thrombi. She recovered with mild residual paralysis of the left upper extremity and was transferred to a rehabilitation facility. CONCLUSIONS: We present a patient with a cerebral infarction after left upper lobectomy. Left upper lobectomy is associated with an increased risk of postoperative thromboembolism. Although the exact mechanism of thrombosis after left upper lobectomy is unclear, a judicious decision should be made regarding epidural catheter placement for postoperative analgesia. More... »

PAGES

27

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12871-019-0695-9

DOI

http://dx.doi.org/10.1186/s12871-019-0695-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112360249

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30797239


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