Related Experiment Video
Updated: Jun 10, 2026
07:17
Establishing a Mouse Contusion Spinal Cord Injury Model Based on a Minimally Invasive Technique
Published on: September 7, 2022
Spinal epidural hematoma
Abdulaziz Al-Mutair1, Drew A Bednar
1Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
The Journal of the American Academy of Orthopaedic Surgeons
|August 3, 2010
Summary
Spinal epidural hematoma causes severe pain and neurological deficits. Urgent surgical decompression is the standard treatment for this rare condition.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Spinal epidural hematoma (SEH) is a rare condition characterized by acute, severe pain and potential for rapid neurological deterioration.
- The exact pathophysiology of SEH is often unclear, but lumbar SEH is frequently associated with the Batson vertebral venous plexus.
- Early diagnosis relies heavily on clinical assessment of pain and neurological deficits.
Purpose of the Study:
- To summarize the clinical presentation, pathophysiology, diagnostic methods, and management of spinal epidural hematoma.
- To highlight the importance of prompt diagnosis and surgical intervention.
Main Methods:
- Review of clinical presentation, including pain characteristics and neurological deficits.
- Discussion of the proposed pathophysiology, particularly the role of the Batson vertebral venous plexus in lumbar SEH.
- Emphasis on Magnetic Resonance Imaging (MRI) as the preferred diagnostic modality.
Main Results:
- SEH typically presents with acute, severe localized pain radiating to extremities.
- Progressive and severe neurological deficits can rapidly develop.
- MRI is the diagnostic method of choice for confirming SEH.
Conclusions:
- Symptomatic spinal epidural hematoma requires urgent surgical decompression of the spinal canal.
- Timely diagnosis through clinical evaluation and MRI is crucial for effective management.
- Understanding the venous plexus involvement aids in comprehending lumbar SEH etiology.
Related Concept Videos
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:25Secondary Spinal Cord Injury llI: Pathophysiology
Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
01:14Spinal Cord Injury ll: Pathophysiology
Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...