[Spontaneous spinal epidural hematomas]

Until now, reports have been given on 249 spontaneous spinal epidural haematomas. Two own cases are included in the submitted analysis. In approximately 78 per cent, the disease begins with pain and radicular disturbances according to the lactation of the haematoma, in 18 per cent with a primary to the location of the haematoma, in 18 per cent with a primary transverse syndrome. The incidence peak is seen around the 60th year of liefe. Men are taken ill more frequently than women, the ratio being 5:3. At the age of 10 to 50 years, the ratio is 3:1. In one third of the patients, no cause of the disease can be detected. One quarter of the patients were given anticoagulants. The prognosis depends on the interval between the first symptoms and the transverse lesion of the cord with paraplegia as well as the time of the operation. For the myelon region (C 1-L 1), the remission rate obtained by an operation within 24 hours after formation of the transverse syndrome is bad in about 34 per cent, for the caudal region (L 2-S 1) it is better in approximately 57 per cent. It the operation is carried out within eight hours, the remission rate is about 84 per cent. In most cases, the disease is diagnosed with a delay and the patients are referred for a surgical treatment too late.