Document Detail

Cerebellar herniation after cervical transforaminal epidural injection.
MedLine Citation:
PMID:  16701197     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study is to inform readers of potential catastrophic complications associated with performing cervical transforaminal epidural steroid injections. CASE REPORT: A 31-year-old man presented to the pain clinic with a history of cervical radicular pain and right upper-extremity radicular symptoms. He was referred from the orthopedic spine clinic for evaluation for epidural steroid injection, having failed conservative treatment consisting of nonsteroidal anti-inflammatory drugs, muscle relaxants, oral steroids, and physical therapy. After undergoing a transforaminal epidural steroid injection at the right C8 nerve root, he developed a cerebellar infarct and brainstem herniation. He survived but has residual deficits of persistent diplopia on right lateral gaze and difficulties with short-term memory loss and concentration. CONCLUSIONS: Although transforaminal epidural steroid injections are an efficacious treatment for radicular syndromes, there can be catastrophic complications. In light of the growing body of similar case reports, further investigation is warranted to establish a safe protocol for the use of this modality.
William A Beckman; Robert J Mendez; Gregory F Paine; Michael A Mazzilli
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Regional anesthesia and pain medicine     Volume:  31     ISSN:  1098-7339     ISO Abbreviation:  Reg Anesth Pain Med     Publication Date:    2006 May-Jun
Date Detail:
Created Date:  2006-05-16     Completed Date:  2007-11-06     Revised Date:  2008-05-20    
Medline Journal Info:
Nlm Unique ID:  9804508     Medline TA:  Reg Anesth Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  282-5     Citation Subset:  IM    
Naval Medical Center, Portsmouth, VA 23708, USA.
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MeSH Terms
Anti-Inflammatory Agents / administration & dosage*,  adverse effects
Brain Infarction / etiology*
Cervical Vertebrae
Injections, Epidural / adverse effects*
Methylprednisolone / administration & dosage*,  adverse effects
Neck Pain / drug therapy*
Reg. No./Substance:
0/Anti-Inflammatory Agents; 83-43-2/Methylprednisolone
Comment In:
Reg Anesth Pain Med. 2007 Mar-Apr;32(2):168; author reply 169-70   [PMID:  17350530 ]
Reg Anesth Pain Med. 2008 Mar-Apr;33(2):190-1   [PMID:  18299101 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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