Rare Case of Ischaemic Stroke Following Cervical Transforaminal Injection

• Published in: European journal of case reports in internal medicine Vol. 6; no. 3; p. 001082
• Main Authors: Ali, Deeba, El Khoumsi, Miriam, Gorur, Yilmaz, Cardos, Benoît, Villalba, Noel Lorenzo
• Format: Journal Article Web Resource
• Language: English
• Published: Italy SMC MEDIA SRL 2019; SMC Media Srl
• Subjects: Cervical epidural steroid injection; Human health sciences; ischaemic stroke; MRI; Neurologie; Neurology; Sciences de la santé humaine; Cervical epidural steroid injection; MRI; ischaemic stroke
• ISSN: 2284-2594; 2284-2594
• DOI: 10.12890/2019_001082

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.
Physicians should be better informed about severe complications following cervical transforaminal epidural steroid injections and their strict indications.Severe adverse events are rare but they can be disastrous.Non-particulate corticosteroid should be used.