Rare Case of Ischaemic Stroke Following Cervical Transforaminal Injection
  • Deeba Ali
    Service des Urgences, CHC Saint-Joseph, Liège, Belgium
  • Miriam El Khoumsi
    Service des Urgences, CHC Saint-Joseph, Liège, Belgium
  • Yilmaz Gorur
    Service de Radiologie, CHU Sart Tilmant, Liège, Belgium
  • Benoît Cardos
    Département des Sciences de la Santé Publique, Université de Liège, Liège, Belgium
  • Noel Lorenzo Villalba
    Service de Médecine Interne et Cancérologie, Centre Hospitalier Saint-Cyr, Villeneuve-sur-Lot, France

Keywords

Cervical epidural steroid injection, ischaemic stroke, MRI

Abstract

We report a case of brainstem infarction following a C5–C6 cervical transforaminal injection, a rare and serious neurological complication of this procedure. Cervical transforaminal steroid injection is a common therapy for patients with persistent cervical radiculopathy not relieved by conservative treatment, and is effective in 65–70% of cases. Unfortunately, this procedure may lead to serious complications such as neurological damage. These complications are rare but potentially fatal, as reported in our case. Complications could be due to three mechanisms: the technique itself, the cervical vascular anatomy and the properties of the product (corticoids). The neurological complications can be diagnosed through brain MRI. This case report focuses on the importance of a risk/benefit evaluation when performing this medical procedure.

VIEW THE ENTIRE ARTICLE

References

  • Bloodworth DM, Perez-Toro MR, Nouri KH. Neurological deficits after epidural steroid injection: time course, differential diagnoses, management, and prognosis suggested by review of case reports. Pain Medicine 2008;9(Suppl 1):S41–S57.

  • Depriester C, Setbon S, Larde A, Malaquin E, Vanden Abeele B, et al. Les infiltrations foraminales cervicales et lombaires sous scanner. Journal de Radiologie Diagnostique et Interventionnelle 2012;93:747–754.

  • Quintero N, Laffont I, Bouhmidi L, Rech C. Paraplégie à la suite d’une infiltration foraminale lombaire et cervicale; revue de la littérature à partir d’un cas. Annales de Réadaptation et de Médecine Physique 2006;49:242–247.

  • Scanlon, Graham C, Moeller-Bertram, Tobias et al. Cervical Transforaminal Epidural Steroid Injections: More Dangerous Than We Think? Spine J 2007;32:1249-1256.

  • Krause D, Guiu B, Leras J-M, Vadanici L, Vignon N, Cercueil J-P, et al. Infiltrations rachidiennes foraminales lombaires analyse des risques potentiels. J Radiol 2010;91:1086–1092.

  • Passia E, Genevay S. Complications des infiltrations rachidiennes. Rev Med Suisse 2017;13:554–558.

  • Thefenne L, Dubecq C, Zing E, Rogez D, Soula M, Escobar E, et al. A rare case of paraplegia complicating a lumbar epidural infiltration. Ann Phys Rehabil Med 2010;53:575–583.

  • Cotten A, Drapé J-L, Sans N, Feydy A, Bartoli J-M, Meder J-F. Recommandation de la SIMS, SFR et FRI-SFR concernant les corticoides injectés en épidural et foraminal. Société Française de Radiologie, 2017.

  • Bose B. Quadriparesis following cervical epidural steroid injections: case report and review of the literature. Spine J 2005;5:558–563.

  • Tiso RL, Cutler T, Catania JA, Whalen K. Adverse central nervous system sequelae after selective transforaminal block: the role of corticosteroids. Spine J 2004;4:468–474.
  • Views: 1382
    HTML downloads: 647
    PDF downloads: 489


    Published: 2019-03-20
    Issue: Vol 6 No 3 (view)


    How to cite:
    1.
    Ali D, El Khoumsi M, Gorur Y, Cardos B, Lorenzo Villalba N. Rare Case of Ischaemic Stroke Following Cervical Transforaminal Injection. EJCRIM 2019;6 doi:10.12890/2019_001082.

    Most read articles by the same author(s)

    << < 1 2