EAJAIC
Eurasian Journal of Anesthesiology and Intensive Care

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

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eISSN: 3023-6738
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Case Report
Spinal epidural hematoma presenting with hypercapnic respiratory failure in diabetic ketoacidosis
Abstract
Spinal epidural hematoma (SEH) is a rare but serious condition that may cause severe neurological deficits. Early diagnosis and surgical treatment are critical for prognosis. This report presents a complex clinical picture in which diabetic ketoacidosis (DKA), pneumosepsis, and SEH coexisted. Informed consent was obtained for presentation. A 70-year-old male patient presenting with weakness and general deterioration was evaluated. Clinical findings, laboratory parameters, imaging studies, and intensive care management were retrospectively analyzed. Initial laboratory evaluation revealed blood glucose of 385 mg/dL, positive urinary ketones (++), arterial blood gas values of pH 7.1, pCO² 56 mmHg, and HCO³ 14 mmol/L, with markedly elevated inflammatory markers (CRP 365 mg/L, procalcitonin 1.7 ng/mL, WBC 37,000/µL). After treatment for pneumosepsis and DKA, the patient was extubated. Following extubation, acute respiratory failure and tetraplegia developed. Emergency contrast-enhanced cervicothoracic magnetic resonance imaging demonstrated an epidural hematoma extending from the C1–2 level to T6, causing anterior compression of the spinal cord. Surgical intervention was not performed due to lesion localization and delayed diagnosis. This case emphasizes the importance of detailed history taking and neurological examination in patients with concurrent metabolic and infectious disorders. In cases of unexplained respiratory failure and neurological deterioration, central causes such as spinal epidural hematoma must be included in the differential diagnosis.

Keywords : Spinal epidural hematoma, diabetic ketoacidosis, hypercapnia, tetraplegia

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Article available in :
Volume 3, Issue 2, 2026
Page : 27-29
https://doi.org/10.51271/EAJAIC-0054
Article Information
Received : 06 Oca 2026
Accepted : 20 Mar 2026
Published : 16 May 2026
Corresponding Author :

Aziz Can Sağıroğlu: Department of Anesthesiology and Reanimation, Trabzon Faculty of Medicine, Trabzon University, Trabzon, Turkiye

[email protected]
Citation : Duman Aydın P, Küçükosman G, Kongur E, Sağıroğlu AC. Spinal epidural hematoma presenting with hypercapnic respiratory failure in diabetic ketoacidosis. Eur J Anesthesiol Intens Care. 2026;3(2):53-55. doi:10.51271/EAJAIC-0054

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