Spontaneous spinal epidural hematoma: A case report

Dinsmore, Amanda; Leonard, Ralph B.; Manthey, David

doi:10.1016/j.jemermed.2004.11.023

Cited by 33 publications

(29 citation statements)

References 19 publications

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“…1) Although SEHs in some patients with mild neurological symptoms can be managed successfully with conservative treatment, early prompt surgical decompression has been the most effective treatment for patients with persistent symptomatic SEHs with neurological deficits. 4) Early surgery within 12 hours correlated with better neurological outcomes. 7) In our case, early surgical evacuation of the hematoma with laminectomy resulted in significant improvement of the associated neurological deficits.…”

Section: Discussionmentioning

confidence: 94%

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Delayed Neurological Deficits Induced by an Epidural Hematoma Associated With a Thoracic Osteoporotic Compression Fracture

Kang

Shin

Lee

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 79-year-old woman developed neurological deficits 6 weeks after the onset of a thoracic osteoporotic compression fracture. Magnetic resonance (MR) imaging of the thoracic spine revealed an epidural hematoma at the T10-L2 levels. Acute decompressive laminectomy and percutaneous vertebroplasty were performed. Following the surgery, the patient's neurologic deficits improved and follow-up MR imaging showed complete resolution of the hematoma. Spinal epidural hematomas are rare and associated delayed neurological deficits are extremely rare. Conservative treatment may be effective for epidural hematomas in neurologically intact patients, but epidural hematomas can be a cause of neural compression and symptomatic deterioration resulting in delayed neurological deficits during the follow-up period

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Section: Discussionmentioning

confidence: 94%

“…SEHs are mostly spontaneous, post-surgical, or post-traumatic including spinal fracture. [2][3][4] The symptoms of post-traumatic SEH are generally present immediately after the incident. Therefore, delayed evolution of progressive neurological deficits are rare and the associated pathogenesis often remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Delayed Neurological Deficits Induced by an Epidural Hematoma Associated With a Thoracic Osteoporotic Compression Fracture

Kang

Shin

Lee

et al. 2012

Neurol. Med. Chir.(Tokyo)

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“…Up to 30% of cases are related to the use of anticoagulants. (4,5) Reported predisposing factors include coagulopathy, anticoagulation, vascular anomaly, disc herniation, Paget's disease, Valsalva manoeuvre, hypertension and neoplasms. (1,5) While SSEH is regarded as a rare entity, its diagnosis is now more frequent than before, owing to the increased availability and use of MR imaging.…”

Section: Discussionmentioning

confidence: 99%

Clinics in diagnostic imaging (150)

Mahmud

Singh

Wong

et al. 2013

smedj

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A 19-year-old Chinese man presented to the emergency department with pain in the lower back, which started soon after he had carried some heavy boxes. He denied any fall or trauma preceding the pain. There was no sciatica or neurological deficit on examination. He maintained a normal gait and anal tone. The lumbar spine radiographs were normal. Magnetic resonance (MR) imaging was requested in order to evaluate his persistent back pain. What do the MR images show? What is the diagnosis? Clinics in diagnostic imaging (150)Nor DIAGNOSISAcute spontaneous spinal epidural haematoma. CLIN ICA L COU RS EThe patient was admitted under the care of a spinal surgeon. Those older than 40 years of age show two peak locations, namely the cervicothoracic and thoracolumbar junctions. M e d ic a l E d u c atio n 668 668The presence of the posterior epidural venous plexus supports the commonly accepted theory of a venous cause to the haematoma, where the valveless venous plexus permits a reversal in blood flow when pressure is increased during injury or activity. On sagittal MR images, SSEH is seen as a biconvex-shaped mass separated from the underlying neural structures by a curvilinear low-signal-intensity structure -the dura mater

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“…As the epidural space is narrowest between T3 and T9, the typically short course from pain to paralysis is common in thoracic and cervical cases (7,9). If left untreated, complete permanent neurological deficits or even death may be seen because of progressive spinal cord compromise (6). However, the exact pathogenesis of the spinal epidural hematomas remains still obscure (11).…”

Section: A Discussionmentioning

confidence: 99%

“…CT myelography has been replaced by MRI as the most suitable diagnostic method for SSEH (6,12,14). The majority of SSEH are located dorsally, with only a few cases were reported in the ventral side (13).…”

Section: A Discussionmentioning

confidence: 99%

Is spontaneous spinal epidural hematoma in elderly patients an emergency surgical case ?

Şirin¹,

Arslan²,

Yaşar³

et al. 2009

Turkish Neurosurgery

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Spontaneous spinal epidural hematoma (SSEH) is a rare condition requiring urgent diagnosis and treatment. Patients with SSEH typically present with acute onset of severe back pain and rapidly develop signs of compression of the spinal cord. The authors present a case with spontaneous resolution of SSEH which is extremely rare. We discuss a man who presented to our clinic with mild paraparesis at the seventh day of his symptoms. He had a history of poorly controlled hypertension and hypercholestrolemia requiring an antihyperlipidemic agent and anticoagulation. His upper level of hypoesthesia was at the third thoracic segment. Cervicothoracic SSEH was diagnosed by magnetic resonance imaging. Since there was a gradual recovery of the neurological deficits beginning 12 hours after the onset of symptoms, surgery was obviated and strict bed rest, serial neurological examinations, and pain controls with opiates were instituted. The neurological deficits showed complete recovery on the 25th day of the clinical course. SSEH is rare and immediate surgical decompression is suggested. Rapid neurological deterioration followed by early and progressive neurological recovery, confirmed by radiological resolution of the lesion, may indicate nonoperative treatment.

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Spontaneous spinal epidural hematoma: A case report

Cited by 33 publications

References 19 publications

Delayed Neurological Deficits Induced by an Epidural Hematoma Associated With a Thoracic Osteoporotic Compression Fracture

Delayed Neurological Deficits Induced by an Epidural Hematoma Associated With a Thoracic Osteoporotic Compression Fracture

Clinics in diagnostic imaging (150)

Is spontaneous spinal epidural hematoma in elderly patients an emergency surgical case ?

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