Cerebral stroke: a differential diagnosis of spinal haemetoma

We report the case of a 84-year-old patient who developed a monoplegia of t he left inferior limb after a spinal anaesthesia for femoral neck's fractur e. The magnetic resonance imaging (MRI) carried out in emergency, eliminate d a spinal compression. The final diagnosis was a cerebral stroke. This obs ervation leads us to discuss the choice of anaesthesia technical, the vario us aetiologies of a neurological trouble after spinal anaesthesia. The appe arance of clinical signs evoking a spinal haematoma, must make seek by the imagery (MRI or scanner) the signs of spinal compression in order to propos e an emergency laminectomy. Finally we insist on the importance but also on the difficulties of the clinical examination in elderly traumatic patients . (C) 2001 Editions scientifiques et medicales Elsevier SAS.