Meningioma is the second most common primary intraspinal tumor. Most spinal meningiomas are located in the intradural extramedullary space and extradural meningiomas are less common. It is quite rare for this tumor to be found in the spinal epidural space of a child. These tumors may be easily confused as a malignant neoplasm because a metastatic lesion commonly located in the epidural space. We report a case of spinal epidural meningioma in a 12-year-old girl. Magnetic resonance findings led to the preoperative diagnosis of a metastatic lesion. The patient underwent total resection of the mass lesion and laminoplasty. She showed an excellent neurological recovery.
Child* ; Diagnosis ; Epidural Neoplasms ; Epidural Space ; Female ; Humans ; Meningioma* ; Spine*

The reports of epidural vascular tumors are rare however dumbbell-shaped epidural cavernous hemangioma is exceedingly rare. The reported incidence of epidural hemangiom is 4%of all spinal epidural tumors and 12% of all intraspinal hemangioma. In the majority of cases, hemangiomas of spinal epidural space represent the secondary extension of a vertebral hemangioma but the occurance of pure epidural cavernous hemangioma is relatively rare. In this report, authors present two cases of epidural cavernous hemangioma including one dembbell-shaped in the thoracic spine with review of other reports.
Epidural Neoplasms ; Epidural Space ; Hemangioma ; Hemangioma, Cavernous* ; Incidence ; Spine*

Epidural blood patch is an effective management for treatment of severe post-dural puncture headache. Here we describe a case of a patient with hip fracture, who was complained regarded as having suspicious post-dural puncture headache after epidural anesthesia, but it failed to be treated with 4 times of epidural blood patch, and later was diagnosed with multiple metastatic brain tumor.
Anesthesia, Epidural ; Blood Patch, Epidural ; Brain Neoplasms* ; Brain* ; Headache ; Hip ; Humans ; Post-Dural Puncture Headache*

The insertion of an epidural catheter into the epidural space to control postoperative pain is very common, as the technique is safe, effective and easy to perform. The numbers of documented problems are remarkably few, particularly those encountered during removal of the catheter. A 65-year-old man with stomach cancer was scheduled for a subtotal gastrectomy. The patient requested epidural analgesia for postoperative pain control. The patient was placed in the right decubitus position, and a 17-gauge Arrow Tuohy needle was inserted midline at the T12-L1 vertebral interspace, with the epidural space located using the loss-of-resistance technique. A 19-gauge Arrow Flextip PlusTM epidural catheter was inserted and advanced 5 cm into the epidural space, without difficulty or resistance. Two days after the administration of epidural analgesia, when the effects of local analgesics and opioid had worn off, an attempt was made to remove the catheter in the sitting position. Increased pressure was applied, but the catheter stretched and the wire reinforcement within the catheter began to uncoil. The removal of the epidural catheter was stopped at this point. After three hours, the patient was placed in the right lateral decubitus position, with his legs flexed to his chest, and another attempt to remove the catheter was successful. Herein, a case of difficulty in removing an obstinate epidural catheter is reported.
Aged ; Analgesia, Epidural ; Analgesics ; Catheters* ; Epidural Space ; Gastrectomy ; Humans ; Leg ; Needles ; Pain, Postoperative ; Stomach Neoplasms ; Thorax

Epidural hemangioma is a rare neoplasm which consists of 4% of epidural tumors and 12% of hemangiomas of vertebral column. But most of them are secondary involvement of epidural space by vertebral hemangioma and pure epidural hemangioma is very rare. Reported cases involve thoracic & lumbar level. Neural foramen & paraspinal region are usually invaded by the tumor mass. Clinical symptoms are similar to simple low back pain or disc herniation. Myelography, CT & MRI are helpful to make diagnosis but pathologic finding is important for final diagnosis. Authors are reporting a case of epidural hemangioma which was difficult to differentiate from HIVD by symptomatology & radiologic findings alone.
Diagnosis ; Epidural Neoplasms ; Epidural Space ; Hemangioma ; Low Back Pain ; Magnetic Resonance Imaging ; Myelography ; Spine

Meningioma arises from the arachnoid cap cell found in the arachnoid layer of the meninges. Most meningiomas are located in the subdural space. Meningiomas are mostly found in adulthood between 20 and 60 years of age. A case of intracranial epidural meningioma without involvement of the subdural space is reported.
Adolescent* ; Arachnoid ; Epidural Neoplasms ; Humans ; Meninges ; Meningioma* ; Subdural Space

Spinal epidural hematoma is a rare event that is usually thought to require immediate surgical therapy. A variety of predisposing factors have been demonstrated for this malady and hemostatic abnormalities are rather frequent in cancer patients. In this report, we present a case of an old man who was diagnosed with early gastric cancer. He had normal coagulation function. After performing hemodynamically stable surgery, an epidural catheter was inserted. The patient underwent reoperation due to postoperative wound bleeding on postoperative day 1. In the evening of the 2nd postoperative day, emergency magnetic resonance imaging (MRI) revealed an epidural hematoma extending from T5 to T8. The patient's coagulation function became even worse. We thought that acute DIC had developed on the patient. Approximately 2 months later, he finally showed spontaneous clinical improvement.
Analgesia, Epidural ; Catheters ; Dacarbazine ; Emergencies ; Hematoma ; Hematoma, Epidural, Spinal ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Reoperation ; Stomach Neoplasms

Spinal epidural hematoma is a rare event that is usually thought to require immediate surgical therapy. A variety of predisposing factors have been demonstrated for this malady and hemostatic abnormalities are rather frequent in cancer patients. In this report, we present a case of an old man who was diagnosed with early gastric cancer. He had normal coagulation function. After performing hemodynamically stable surgery, an epidural catheter was inserted. The patient underwent reoperation due to postoperative wound bleeding on postoperative day 1. In the evening of the 2nd postoperative day, emergency magnetic resonance imaging (MRI) revealed an epidural hematoma extending from T5 to T8. The patient's coagulation function became even worse. We thought that acute DIC had developed on the patient. Approximately 2 months later, he finally showed spontaneous clinical improvement.
Analgesia, Epidural ; Catheters ; Dacarbazine ; Emergencies ; Hematoma ; Hematoma, Epidural, Spinal ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Reoperation ; Stomach Neoplasms

Continuous epidural analgesia with morphine via portable infusor(Baxter Infusor, BI) is a good technique for the management of intractable cancer pain. The method of subcutaneous tunnelling with portable infusor has been widely used for the cancer pain management. We examined the doses of morphine, duration of subcutaneous tunnelling, side effects, age distribution and causes of pain. The mean initial dose of morphine was 6.09 and the last 24.02 mg. Mean duration of subcutaneous tunnelling was 53.71 days and voiding difficulty, pruritus, respiratory depression were observed. Most of the patients were at the ages of 6th decade and the most common cause of pain was stomach cancer. It is suggested that the management of intractable cancer pain with epidural morphine through subcutaneous tunnelling via portable infusor is satisfactory and reliable.
Age Distribution ; Analgesia, Epidural ; Humans ; Infusion Pumps* ; Morphine ; Pain Management ; Pruritus ; Respiratory Insufficiency ; Stomach Neoplasms

BACKGROUND: Respiratory complications have been the main cause of death after a resection of esophageal cancer. This retrospective study was conducted to investigate the effect of thoracic epidural analgesia on respiratory complications after a resection of esophageal cancer. METHODS: This study enrolled two groups of patients undergoing an esophageal resection during a 7-year period. The first group (control group) was comprised of 105 patients in whom thoracic epidural analgesia was not used. The second group (epidural group) was comprised of 121 patients in whom thoracic epidural analgesia was done routinely. The latter group received an initial bolus of 0.1% bupivacaine 10 ml with 2 mg of morphine at the end of surgery and an infusion of 2 ml/hr of the solution comprised of 0.1% bupivacaine with 0.2 mg/ml morphine for 3 days. The incidence of respiratory complications and the duration of ventilator care and ICU stay were investigated by reviewing of charts. RESULTS: There were no significant differences in the incidence of respiratory complications and the duration of ventilator care and ICU stay in both groups. CONCLUSIONS: The results of this study suggest that the routine use of thoracic epidural analgesia did not reduce the incidence of respiratory complications after resection of esophageal cancer.
Analgesia, Epidural* ; Bupivacaine ; Cause of Death ; Esophageal Neoplasms* ; Humans ; Incidence ; Morphine ; Retrospective Studies ; Ventilators, Mechanical