• A&A practice · Jul 2024

    Case Reports

    Subdural Spread of Local Anesthetic Mimicking Cerebrovascular Accident: A Case Report of Horner's Syndrome, Upper Limb Paresthesia, and Motor Weakness After Thoracic Epidural Analgesia.

    • Jacqueline Measer, Andrew Gray, and Matthias Braehler.
    • From the Department of Anesthesia and Perioperative Care, University of California San Francisco (UCSF), San Francisco, California.
    • A A Pract. 2024 Jul 1; 18 (7): e01812e01812.

    AbstractA 53-year-old woman underwent a thoracic epidural placement for a scheduled laparotomy. Postoperatively the patient had no appreciable epidural level after multiple epidural boluses and was noted to be severely hypotensive with right upper extremity weakness and numbness. She subsequently developed right-sided Horner's syndrome with worsening right upper extremity weakness and decreased sensation from C6 to T1. She regained full motor and sensory function in her right upper extremity with epidural removal. This unusual case raises awareness of the variability in the presentation of subdural spread and provides an example of an epidural complication that can mimic a cerebrovascular accident (CVA).Copyright © 2024 International Anesthesia Research Society.

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