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Spontaneous Spinal Epidural Hematoma of Unknown Etiology: Case Report and Literature Review

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Abstract

Introduction

Our objective is to emphasize the importance of recognizing and rapidly treating spontaneous spinal epidural hematoma (SSEH). SSEH is a pathologic entity traditionally thought to be exceptionally rare but which, in the era of MR imaging, is becoming increasingly prevalent, and which if treated with sufficient rapidity can be completely curable.

Clinical Presentation

Our particular case presented with clumsiness, neck pain with radiation to both arms, and bilateral arm weakness. According to the literature surveyed, most patients present with severe back and/or neck pain, often with a radicular component, followed by motor and/or sensory deficits.

Intervention/Technique

C5-6 decompressive hemilaminectomy with evacuation of hematoma.

Conclusion

As evidenced in the literature, outcome depends on time to operation and prognosis is impacted by age and preoperative deficit. Because of the high risk of poor outcome without treatment, SSEH should always be a diagnostic consideration in patients whose presentation is even slightly suggestive. Rapid, appropriate treatment of these patients can often lead to complete recovery of function, whereas any delay in appropriate treatment can be catastrophic.

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Acknowledgments

The authors are grateful for the editorial assistance rendered by Ms. Jessica Kazmier. The authors have no financial interests to disclose.

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Authors and Affiliations

  1. Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 2210, Chicago, IL, 60611, USA

    Robert H. Thiele, Ziad A. Hage, Stephen L. Ondra & H. Hunt Batjer

  2. Departments of Neurological Surgery and Radiology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 2210, Chicago, IL, 60611, USA

    Daniel L. Surdell & Bernard R. Bendok

Authors
  1. Robert H. Thiele
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  2. Ziad A. Hage
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  3. Daniel L. Surdell
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  5. H. Hunt Batjer
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  6. Bernard R. Bendok
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Correspondence to Bernard R. Bendok.

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Thiele, R.H., Hage, Z.A., Surdell, D.L. et al. Spontaneous Spinal Epidural Hematoma of Unknown Etiology: Case Report and Literature Review. Neurocrit Care 9, 242–246 (2008). https://doi.org/10.1007/s12028-008-9083-x

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  • DOI: https://doi.org/10.1007/s12028-008-9083-x

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