Postoperative Leg Weakness, Numbness, And Urinary Incontinence


Consult Page

58M acute BLE weakness and urinary incontinence, postop neurosurgery patient

Initial Imaging

Fig. 71.1, Sagittal (A) and axial (B) T2-weighted MRI of the thoracic spine without contrast demonstrates a large posterior epidural fluid collection (asterisk) from T6 to T10. The dura (arrows) is displaced anteriorly with effacement of the thecal sac.

Walking Thoughts

  • What surgery did the patient have? When was the patient’s surgery?

  • Were there any complications or concerns from the prior operation?

  • What was his postoperative course? When and where did he discharge?

  • What is the patient’s baseline neurological function, and what was his function after surgery?

  • What is his current neurological exam?

  • How acute, severe, and progressive are his neurological symptoms?

  • Does the patient have any risk factors for postoperative bleeding (e.g. coagulopathy or liver disease)?

  • Are coagulation labs available or pending?

  • Are the imaging findings consistent with the patient’s symptoms and neurological exam?

  • Does this patient need to go to the operating room and if so, when?

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