Zusammenfassung
Spontane spinale epidurale Hämatome sind selten, jedoch aufgrund ihres potenziell dramatischen Verlaufs bis hin zum irreversiblen neurologischen Defizit von differenzialdiagnostischer Bedeutung. Die klinischen Beschwerden sind initial nicht wegweisend, so wird die Diagnose in den meisten Fällen verzögert durch die sich entwickelnde neurologische Ausfallsymptomatik gestellt. Es wird der Fall einer 73-jährigen Patientin präsentiert, die anfänglich uncharakteristische Nackenbeschwerden berichtet und am Folgetag eine inkomplette Tetraparese aufweist, sowie eines 78-jährigen Patienten, der perakute Rückenschmerzen erleidet und nach kurzer Zeit eine Paraparese entwickelt. Durch eine frühzeitige mikrochirurgische Spinalkanalevakuation kam es in beiden Fällen im Verlauf zu einer vollständigen Rückbildung des neurologischen Defizits.
Abstract
Spontaneous spinal epidural hematomas are rare but are of differential diagnostic importance due to the potentially dramatic progression through to irreversible neurological deficits. At the beginning the clinical symptoms are non-specific and the development of neurological deficits leads to the diagnosis. We present the case of a 73-year-old female patient who initially reported uncharacteristic neck pain and developed incomplete quadriplegia during the next day as well as the case of a 78-year-old male patient, who complained of acute back pain and developed paraplegia a short time afterwards. Early microsurgery and spinal canal evacuation led to complete remission of the neurological deficits in both cases.
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Interessenkonflikt. M. Spalteholz und L. Rödel geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Spalteholz, M., Rödel, L. Spontanes spinales Epiduralhämatom als Ursache eines inkompletten Transversalsyndroms. Orthopäde 42, 971–974 (2013). https://doi.org/10.1007/s00132-013-2185-y
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DOI: https://doi.org/10.1007/s00132-013-2185-y