[Spontaneous spinal hemorrhage. Outcome after surgical therapy of epidural hematomas]

Eight patients with spontaneous spinal epidural hemorrhages are presented. All eight initially had suffered from severe neck or back pain. In seven cases, progressive neurological deficits had developed, some of which led to complete paraplegia. On all eight patients operations were performed. After an average of 11 weeks' follow-up, full recovery from the preoperative pain and neurological deficits could be seen in 6 of the patients. If spinal hemorrhage is treated by decompression at an early stage, there is a good prognosis with respect to pain and neurological deficits. It was found that neurological deficits sometimes showed complete improvement, even if they were older than 36 hours before surgery was performed. In cases of severe local complaints in combination with progressive neurological deficits a spinal hemorrhage always must be considered. The best diagnostic method is magnetic resonance imaging.