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Diagnosis and microsurgery of symptomatic spontaneous spinal epidural hematoma

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Abstract

Background

Symptomatic spontaneous spinal epidural hematoma (SSEH) is an uncommon cause of cord compression that needs emergent treatment. Without effective management of the symptomatic SSEH, irreversible severe spinal injury would be possible.

Objectives

We aimed to investigate the diagnosis and surgical management of symptomatic SSEH.

Methods

Five cases of symptomatic SSEH with favorable neurological recovery after emergent microsurgery were prospectively analysed.

Results

The main clinical presentations were root pain and palsy. The main manifestations of MRI were long-segment epidural lesions of high intensity on T1- and T2-weighted images without enhancement. Laminectomy via posterior approach and hematoma removal were undergone for all patients. All patients achieved full neurological recovery without complications.

Conclusions

MRI manifestation assisted with the main clinical symptoms may aid the preoperative diagnosis of SSEH, and the delay in obtaining preoperative Digital subtraction angiography is worthwhile, especially for those with progressive neurological deterioration.

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References

  1. Padosch SA, Dettmeyer RB, Schmidt PH et al (2006) Spinal epidural haematoma after blunt trauma to the neck and hyperflection of the cervical spine. Forensic Sci Int 159:230–234

    Article  CAS  PubMed  Google Scholar 

  2. Seet RC, Lim EC, Wilder-Smith EP et al (2005) Spontaneous epidural haematoma presenting as cord compression in a patient receiving clopidogrel. Eur J Neurol 12:811–812

    Article  CAS  PubMed  Google Scholar 

  3. Steinmetz MP, Kalfas IH, Willis B et al (2003) Successful surgical management of a case of spontaneous epidural hematoma of the spine during pregnancy. Spine J 3:539–542

    PubMed  Google Scholar 

  4. Ananthababu PS, Anbuselvam M, Radhakrishnan MK (2005) Spontaneous spinal epidural haematoma: report of two cases and review of the literature. J Clin Neurosci 12:90–92

    Article  CAS  PubMed  Google Scholar 

  5. Bracken MB, Shepard MJ, Collins WF et al (1990) A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. N Engl J Med 322(20):1405–1411

    Article  CAS  PubMed  Google Scholar 

  6. Groen RJ (2004) Non-operative treatment of spontaneous spinal epidural hematomas: a review of the literature and a comparison with operative cases. Acta Neurochir (Wien) 146:103–110

    Article  CAS  Google Scholar 

  7. Hsieh CF, Lin HJ, Chen KT et al (2006) Acute spontaneous cervical spinal epidural hematoma with hemiparesis as the initial presentation. Eur J Emerg Med 13:36–38

    Article  PubMed  Google Scholar 

  8. Hess EP, Sztajnkrycer MD (2005) Images in emergency medicine. Spontaneous cervicothoracic epidural hematoma. Ann Emerg Med 46:382–392

    Article  PubMed  Google Scholar 

  9. Van Schaeybroeck P, Van Calenbergh F, Van De Werf F, Demaerel P, Goffin J, Plets C (1998) Spontaneous spinal epidural hematoma associated with thrombolysis and anticoagulation therapy: report of three cases. Clin Neurol Neurosurg 100(4):283–287

    Article  PubMed  Google Scholar 

  10. Kebaish KM, Awad JN (2004) Spinal epidural hematoma causing acute cauda equina syndrome. Neurosurg Focus 16:e1

    Article  PubMed  Google Scholar 

  11. Kong JK, Mak KH (2003) Spontaneous spinal epidural haematoma—an unusual cause of spinal cord compression. Hong Kong Med J 9:55–57

    CAS  PubMed  Google Scholar 

  12. Kreppel D, Antoniadis G, Seeling W (2003) Spinal hematoma: a literature survey with meta-analysis of 613 patients. Neurosurg Rev 26:1–49

    Article  CAS  PubMed  Google Scholar 

  13. Holtas S, Heiling M, Lönntoft M (1996) Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation. Radiology 199:409–413

    CAS  PubMed  Google Scholar 

  14. Nourbakhsh A, Chaljub G, Garges KJ (2009) Spontaneous cervical epidural hematoma masquerading as an abscess on magnetic resonance imaging scan. J Manipulative Physiol Ther 32(5):391–395

    Article  PubMed  Google Scholar 

  15. Thiele RH, Hage ZA, Surdell DL et al (2008) Spontaneous spinal epidural hematoma of unknown etiology: case report and literature review. Neurocrit Care 9:242–246

    Article  PubMed  Google Scholar 

  16. Morales Ciancio RA, Drain O, Rillardon L et al (2008) Acute spontaneous spinal epidural hematoma: an important differential diagnosis in patients under clopidogrel therapy. Spine J 8:544–547

    Article  PubMed  Google Scholar 

  17. Park J, Lee JB, Park JY et al (2007) Spinal cord infarction after decompressive laminectomy for spontaneous spinal epidural hematoma—case report. Neurol Med Chir (Tokyo) 47:325–327

    Article  Google Scholar 

  18. De Wyngaert R, Ghysen D, Bellinck P et al (2007) Spontaneous spinal epidural hematoma. JBR-BTR 90:186–187

    PubMed  Google Scholar 

  19. Lawton MT, Porter RW, Heiserman JE et al (1995) Surgical management of spinal epidural hematoma: relationship between surgical timing and neurological outcome. J Neurosurg 83:1–7

    Article  CAS  PubMed  Google Scholar 

  20. Kwon BK, Mann C, Sohn HM et al (2008) Hypothermia for spinal cord injury. Spine J 8(6):859–874

    Article  PubMed  Google Scholar 

  21. Matsumura A, Namikawa T, Hashimoto R et al (2008) Clinical management for spontaneous spinal epidural hematoma: diagnosis and treatment. Spine J 8(3):534–537

    Article  PubMed  Google Scholar 

  22. Liu Z, Jiao Q, Xu J et al (2008) Spontaneous spinal epidural hematoma: analysis of 23 cases. Surg Neurol 69(3):253–260

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Hangzhou Second Hospital, College of Medicine, Hangzhou Normal University, Hangzhou, 310015, China

    W. Qiu, C. Guo, Z. Wu & M. Ding

  2. Department of Orthopedics, Shaoxing People’s Hospital, Shaoxing, 312000, China

    W. Sun

  3. Brain Medicine Institute, College of Medicine, Zhejiang University, Hangzhou, 310009, China

    W. Qiu, W. Sun, M. Ding & H. Shen

Authors
  1. W. Qiu
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  2. W. Sun
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  3. C. Guo
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  4. Z. Wu
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  5. M. Ding
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  6. H. Shen
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Corresponding author

Correspondence to H. Shen.

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Qiu, W., Sun, W., Guo, C. et al. Diagnosis and microsurgery of symptomatic spontaneous spinal epidural hematoma. Ir J Med Sci 180, 241–245 (2011). https://doi.org/10.1007/s11845-010-0533-z

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  • DOI: https://doi.org/10.1007/s11845-010-0533-z

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