Discoblock‐Associated Subarachnoid Hemorrhage: A Case Report

The discoblock procedure entails the administration of an anesthetic agent during discography to pinpoint the origin of spinal pain in challenging diagnostic scenarios. Known for its minimal complication rate, the most frequently documented adverse effect is discitis. This case report introduces a n...

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Published in:Case reports in neurological medicine Vol. 2025; no. 1; p. 5167713
Main Authors: Sonbol, Ahmed M., Ewais, Abdel Fattah, Kassab, Farid, Khalid, Khalid Mohammed Ali, Mohammed, Mohammed Awad A., Ali, Hassan Sirajaldeen Alhassan, Elgack, Mohammed M.
Format: Journal Article
Language:English
Published: United States John Wiley & Sons, Inc 01.01.2025
Wiley
Subjects:
Back pain
Back surgery
Backache
Brain research
Bupivacaine
Cerebrospinal fluid
Contrast agents
Convulsions & seizures
Diagnosis
Epidural
Epilepsy
Headaches
Hemorrhage
Magnetic resonance imaging
Medical imaging
Neurosurgery
Scoliosis
Stroke (Disease)
Subarachnoid hemorrhage
Saudi Arabia
discoblock
iohexol
cefazolin
subarachnoid hemorrhage
discography
ISSN:2090-6668, 2090-6676
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Abstract The discoblock procedure entails the administration of an anesthetic agent during discography to pinpoint the origin of spinal pain in challenging diagnostic scenarios. Known for its minimal complication rate, the most frequently documented adverse effect is discitis. This case report introduces a novel observation of subarachnoid hemorrhage following a discoblock procedure. Initially presenting with persistent lower back pain, the patient exhibited dehydrated lumbar discs on imaging, characterized by altered T2 signal intensity and a diffuse disc bulge impacting the anterior thecal sac at the L4‐5 level, alongside degenerative scoliosis at L2‐3. These findings suggested the potential origins of symptoms at L4‐5 or L2‐3, leading to the decision to proceed with L4‐5 discoblock. Symptom alleviation postdiscoblock, coupled with prophylactic cefazolin administration, indicated the necessity for further management at the L4‐5 disc level. Subsequently, the patient presented with status epilepticus 9 hours later, with brain magnetic resonance imaging revealing anomalous hyperintensities in the left temporoparietal sulci and the left ambient cistern, prompting suspicion of subarachnoid hemorrhage. This study elucidates the procedural indications for discoblock, explores potential factors contributing to complications, and delves into the safety considerations surrounding this intervention.
AbstractList The discoblock procedure entails the administration of an anesthetic agent during discography to pinpoint the origin of spinal pain in challenging diagnostic scenarios. Known for its minimal complication rate, the most frequently documented adverse effect is discitis. This case report introduces a novel observation of subarachnoid hemorrhage following a discoblock procedure. Initially presenting with persistent lower back pain, the patient exhibited dehydrated lumbar discs on imaging, characterized by altered T2 signal intensity and a diffuse disc bulge impacting the anterior thecal sac at the L4-5 level, alongside degenerative scoliosis at L2-3. These findings suggested the potential origins of symptoms at L4-5 or L2-3, leading to the decision to proceed with L4-5 discoblock. Symptom alleviation postdiscoblock, coupled with prophylactic cefazolin administration, indicated the necessity for further management at the L4-5 disc level. Subsequently, the patient presented with status epilepticus 9 hours later, with brain magnetic resonance imaging revealing anomalous hyperintensities in the left temporoparietal sulci and the left ambient cistern, prompting suspicion of subarachnoid hemorrhage. This study elucidates the procedural indications for discoblock, explores potential factors contributing to complications, and delves into the safety considerations surrounding this intervention.The discoblock procedure entails the administration of an anesthetic agent during discography to pinpoint the origin of spinal pain in challenging diagnostic scenarios. Known for its minimal complication rate, the most frequently documented adverse effect is discitis. This case report introduces a novel observation of subarachnoid hemorrhage following a discoblock procedure. Initially presenting with persistent lower back pain, the patient exhibited dehydrated lumbar discs on imaging, characterized by altered T2 signal intensity and a diffuse disc bulge impacting the anterior thecal sac at the L4-5 level, alongside degenerative scoliosis at L2-3. These findings suggested the potential origins of symptoms at L4-5 or L2-3, leading to the decision to proceed with L4-5 discoblock. Symptom alleviation postdiscoblock, coupled with prophylactic cefazolin administration, indicated the necessity for further management at the L4-5 disc level. Subsequently, the patient presented with status epilepticus 9 hours later, with brain magnetic resonance imaging revealing anomalous hyperintensities in the left temporoparietal sulci and the left ambient cistern, prompting suspicion of subarachnoid hemorrhage. This study elucidates the procedural indications for discoblock, explores potential factors contributing to complications, and delves into the safety considerations surrounding this intervention.
The discoblock procedure entails the administration of an anesthetic agent during discography to pinpoint the origin of spinal pain in challenging diagnostic scenarios. Known for its minimal complication rate, the most frequently documented adverse effect is discitis. This case report introduces a novel observation of subarachnoid hemorrhage following a discoblock procedure. Initially presenting with persistent lower back pain, the patient exhibited dehydrated lumbar discs on imaging, characterized by altered T2 signal intensity and a diffuse disc bulge impacting the anterior thecal sac at the L4‐5 level, alongside degenerative scoliosis at L2‐3. These findings suggested the potential origins of symptoms at L4‐5 or L2‐3, leading to the decision to proceed with L4‐5 discoblock. Symptom alleviation postdiscoblock, coupled with prophylactic cefazolin administration, indicated the necessity for further management at the L4‐5 disc level. Subsequently, the patient presented with status epilepticus 9 hours later, with brain magnetic resonance imaging revealing anomalous hyperintensities in the left temporoparietal sulci and the left ambient cistern, prompting suspicion of subarachnoid hemorrhage. This study elucidates the procedural indications for discoblock, explores potential factors contributing to complications, and delves into the safety considerations surrounding this intervention.
The discoblock procedure entails the administration of an anesthetic agent during discography to pinpoint the origin of spinal pain in challenging diagnostic scenarios. Known for its minimal complication rate, the most frequently documented adverse effect is discitis. This case report introduces a novel observation of subarachnoid hemorrhage following a discoblock procedure. Initially presenting with persistent lower back pain, the patient exhibited dehydrated lumbar discs on imaging, characterized by altered T2 signal intensity and a diffuse disc bulge impacting the anterior thecal sac at the L4-5 level, alongside degenerative scoliosis at L2-3. These findings suggested the potential origins of symptoms at L4-5 or L2-3, leading to the decision to proceed with L4-5 discoblock. Symptom alleviation postdiscoblock, coupled with prophylactic cefazolin administration, indicated the necessity for further management at the L4-5 disc level. Subsequently, the patient presented with status epilepticus 9hours later, with brain magnetic resonance imaging revealing anomalous hyperintensities in the left temporoparietal sulci and the left ambient cistern, prompting suspicion of subarachnoid hemorrhage. This study elucidates the procedural indications for discoblock, explores potential factors contributing to complications, and delves into the safety considerations surrounding this intervention.
Audience Academic
Author Khalid, Khalid Mohammed Ali
Mohammed, Mohammed Awad A.
Kassab, Farid
Sonbol, Ahmed M.
Ewais, Abdel Fattah
Ali, Hassan Sirajaldeen Alhassan
Elgack, Mohammed M.
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Keywords discoblock
iohexol
cefazolin
subarachnoid hemorrhage
discography
Language English
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SubjectTerms Back pain
Back surgery
Backache
Brain research
Bupivacaine
Cerebrospinal fluid
Contrast agents
Convulsions & seizures
Diagnosis
Epidural
Epilepsy
Headaches
Hemorrhage
Magnetic resonance imaging
Medical imaging
Neurosurgery
Scoliosis
Stroke (Disease)
Subarachnoid hemorrhage
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Title Discoblock‐Associated Subarachnoid Hemorrhage: A Case Report
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