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[Spontaneous spinal epidural hematoma].

M E García Garcia1, V de Las Heras, M Kurtis Urra

  • 1Departamento de Neurología, Hospital Clínico de San Carlos, Madrid, Spain. cochemxj@hotmail.com

Neurologia (Barcelona, Spain)
|March 28, 2008
PubMed
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Spontaneous spinal epidural hematoma is a rare neurosurgical emergency causing acute neurological deficits. Prompt diagnosis via MRI and surgical decompression are crucial for favorable outcomes.

Area of Science:

  • Neurosurgery
  • Neurology
  • Radiology

Background:

  • Spontaneous spinal epidural hematoma (SSEH) is a rare condition with an incidence of approximately one per million per year.
  • SSEH is characterized by the absence of a known underlying cause or predisposing bleeding factor.
  • It presents a significant risk of acute and irreversible neurological damage, necessitating urgent medical attention.

Observation:

  • The typical clinical presentation includes acute vertebral pain with radiation to the limbs, followed by neurological deficits.
  • Magnetic resonance imaging (MRI) is the preferred diagnostic modality for determining hematoma topography and confirming the diagnosis.
  • While rare spontaneous resolutions have been reported, most cases require surgical intervention.

Findings:

Related Experiment Videos

  • This report details a case of a 65-year-old woman with hypertension presenting with SSEH.
  • Her initial symptoms included severe interscapular pain radiating to both upper limbs, followed by right-sided hemiparesis.
  • These symptoms were indicative of a spontaneous spinal epidural hematoma.

    • Implications:

    • SSEH is a critical neurosurgical emergency requiring rapid diagnosis and treatment.
    • Timely surgical decompression, typically via laminectomy and hematoma drainage, is often necessary to prevent permanent neurological injury.
    • This case underscores the importance of considering SSEH in patients presenting with acute neurological deficits and severe spinal pain.