Spontaneous spinal epidural haematoma: A retrospective study of a series of 13 cases

González, A. Muñoz; Cuello, Juan Pablo; Cruz, Patrícia; Mohedano, A.M. Iglesias; Rubio, R. Domínguez; Delgado, Francisco; Pastor, A. García; Guzmán-De-Villoria, Juan A; García, P. Fernández; Martínez, Julia Romero; Echevarri, D. Ezpeleta; Otero, Francisco Javier Sanjiao; Alén, P. Vázquez; Osorio, José; Núñez, A. Gil

doi:10.1016/j.nrleng.2014.03.005

Cited by 11 publications

(25 citation statements)

References 26 publications

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“…There, the epidural venous plexus is vulnerable to sudden changes in pressure. In most of the published cases, only venous oozing was seen peroperatively [14]. Bansal et al reported the occurrence of non-traumatic spinal epidural hematoma in a pregnant woman with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome [15].…”

Section: Review Of Literaturementioning

confidence: 99%

A brief review of literature of spontaneous spinal epidural hematoma in the context of an idiopathic spinal epidural hematoma

Unnithan¹

2019

Egypt J Neurosurg

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Background: There is a debate over the origin of bleeding in case of spontaneous spinal epidural hematoma (SSEH). The most widely accepted theory is of venous origin. Since the epidural veins are valveless, there will be increased venous pressure transmitted from intrathoracic and intraabdominal compartments on straining, causing rupture. Another view is that only arterial bleeding can cause rapid compression of spinal cord, since the venous pressure is less than intrathecal pressure. There is a lack of consensus on treatment also. Most of the authors recommend urgent decompressive laminectomy. There is a recent trend towards less invasive options such as partial laminectomy and hemilaminectomy and conservative treatment. Aim, materials, and methods: Aim of this study is to review the theories about the origin of bleeding in spontaneous spinal epidural hematoma and the methods of treatment. Literature search was done in PubMed for theories of the origin of spontaneous spinal epidural hematoma and the treatment methods. Descriptive analysis was done. Case presentation: A 49-year-old male stoneworker presented with thoracic back pain of acute onset while doing work, followed by weakness of forearm and legs. He had paraplegia with grade 1 power of lower limbs. MRI showed posterior epidural hematoma from C3 to T4. Midline partial laminectomy was done from C5 to T2. Hematoma was evacuated. His power improved over 1 week. Later CT (computed tomography) angiography showed no vascular malformation. Conclusion: Cervical location and rapid development of weakness point towards arterial origin of spontaneous spinal epidural hematoma. Thoracic location and presence of peroperative venous ooze suggest venous origin. Partial or hemilaminectomy is recommended to reduce postoperative instability. Conservative treatment is preferred in case of coagulopathy.

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Section: Review Of Literaturementioning

confidence: 99%

A brief review of literature of spontaneous spinal epidural hematoma in the context of an idiopathic spinal epidural hematoma

Unnithan¹

2019

Egypt J Neurosurg

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“…SSEH is usually seen as isointense or hypointense lesions on T1-weighted images and hyper intense on T2-weighted images in the early MRI imaging. MRI is also a valuable tool in differentiating acute SSEH from epidural neoplastic mass or abscess based on specific signal changes, contrast enhancement and anatomical/pathological findings [2,24,25]. Authors support the theory that pathogenesis of SSEH is closely connected to both arterial and venous blood vessels [26].…”

Section: Discussionmentioning

confidence: 85%

“…Risk factors associated with SSEH are proven to be are: anticoagulant therapy and thrombolysis therapy for cardiac related diseases [15][16][17], non-regulated hypertension [18], hemodialysis dependent renal disease [19], chronic antiplatelet drugs usage [2,15,17] and some congenital diseases with factor XI deficiency like hemophilia B [7].…”

Section: Discussionmentioning

confidence: 99%

“…Contrary to the previous sentence recent paper claims that the outcomes of conservative approach are very poor, especially in the cervical leveled lesions [30,33]. Post-OP mortality of SSEH ranges from 3% to 6% [1][2][3]. Size and location of hematoma, pre-operative neurological deficits and timing of the surgical decompression is directly connected to the prognosis [23,30,33].…”

Section: Discussionmentioning

confidence: 99%

“…It is still considered to be a rare, dangerous and very important cause of spinal cord compression [2]. The incidence of SSEH stands at 0.1 patients per 100,000 patients currently accounts for less than 1% of spinal space lesions [3].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute Quadriplegia Caused by Idiopathic Spontaneous Epidural Haematoma in Young Adult-Case Report and Review of Literature

GoluboviAA¹,

CigiAA²,

PapiAA³

et al. 2016

Int J Phys Med Rehabil

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An unusual case of ventral spontaneous thoracic epidural hematoma

Zhou

2024

Clinical Case Reports

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Key Clinical MessageSpontaneous spinal epidural hematoma (SSEH) rarely occurs. Without early diagnosis, SSEH can lead to the acute onset of neurologic deficits. We report the case of a 65‐year‐old male with diabetes mellitus who was admitted to our emergency department with a chief complaint of sharp and severe pain in the left scapula and behind the sternum. He was misdiagnosed with cardiovascular disease until the onset of progressive bilateral paraplegia and lower limb numbness. Magnetic resonance imaging revealed a ventral thoracic SSEH. Surgical treatment to remove epidural hematoma and laminectomy for decompression were performed. Except for urine retention, bilateral lower limb paraplegia and numbness were alleviated postoperatively. Due to the high risk of poor neurological outcomes without treatment or with delayed intervention, timely surgical evacuation of the hematoma and hemostasis are recommended to ensure favorable neurological outcomes.

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Spontaneous spinal epidural haematoma: A retrospective study of a series of 13 cases

Cited by 11 publications

References 26 publications

A brief review of literature of spontaneous spinal epidural hematoma in the context of an idiopathic spinal epidural hematoma

A brief review of literature of spontaneous spinal epidural hematoma in the context of an idiopathic spinal epidural hematoma

Acute Quadriplegia Caused by Idiopathic Spontaneous Epidural Haematoma in Young Adult-Case Report and Review of Literature

An unusual case of ventral spontaneous thoracic epidural hematoma

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