Spinal Epidural Hematoma: A Case Series and the Current Paradigm

Area of Science:

• Neurosurgery
• Neurology
• Spinal Cord Medicine

Background:

• Spinal epidural hematoma (SEH) is a rare but serious condition involving blood accumulation in the spinal epidural space.
• Untreated SEH can lead to permanent neurological deficits, including paralysis.
• Early recognition and management are critical for favorable patient outcomes.

Observation:

• This report details three cases of SEH: one spontaneous and two traumatic.
• All patients received timely diagnosis and intervention.
• Surgical evacuation of the hematoma was performed.

Findings:

• All three patients experienced significant neurological recovery following prompt treatment.
• Minimizing laminectomy extent during SEH evacuation reduced the risk of post-laminectomy kyphosis.
• Avoiding spinal instrumentation was possible in these cases with limited laminectomy.

Implications:

• Timely diagnosis and surgical evacuation are crucial for favorable outcomes in SEH.
• Conservative surgical approaches, such as limited laminectomy, may prevent complications like post-laminectomy kyphosis.
• Further research is needed to refine SEH treatment protocols and enhance patient recovery.