J Korean Neurotraumatol Soc.  2011 Oct;7(2):51-56. 10.13004/jknts.2011.7.2.51.

Retrospective Analysis of 14 Cases of Spinal Epidural Hematoma

• Kim BS
• Lee SB
• Kim JH
• Lee TG
• Yoo DS
• Huh PW
• Cho KS

• KMID: 2019913
• DOI: http://doi.org/10.13004/jknts.2011.7.2.51

Abstract

OBJECTIVE
Spinal epidural hematoma (SEH) is rare diseases and they may have various causes. We reviewed our clinical experiences and analyzed the various factors related to the outcome for SEH.
METHODS
We investigated 14 patients (8 men and 6 women) who underwent hematoma removal for SEH from January 2003 to December 2010. We investigated age, gender, hypertension, anticoagulant use, radiographic finding such as the degree of cord compression and the extent and location of the hematoma and relationship between preoperative neurologic status, surgical timing and neurological outcome using the Japanese Orthopaedic Association (JOA) score by examining medical records.
RESULTS
In ten cases (71.4%) of operated 14 cases, there were post-operative improvements (recovery scale >50%) in clinical symptoms. We performed operation within 12 hour for seven cases, and the average of recovery scale for these cases was 69.9%. Six (85.7%) of these cases improved more than 50% on the recovery scale. There were seven cases that we performed operations on that were beyond 12 hour, and the average of the recovery scale was 47.7%. The average of the recovery scale in cases of incomplete injury after the operation was 64.4%, and the average of the recovery scale was 38.1% in cases of complete injury. There was a significant difference between two groups (p<0.05).
CONCLUSION
Our present study demonstrates that surgical time interval and preoperative neurological status correlated with neurological recovery. The rapidity of surgical intervention and preoperative favorable neurological status maximize neurological recovery.

Keyword

Traumatic subdural hygroma; Chronic subdural hematoma; Head injuries; Old ages

MeSH Terms

Asian Continental Ancestry Group
Craniocerebral Trauma
Hematoma
Hematoma, Epidural, Spinal
Hematoma, Subdural, Chronic
Humans
Hypertension
Male
Operative Time
Rare Diseases
Retrospective Studies

Figure

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  FIGURE 1. Preoperative and Postoperative MRI of 61 year-old male patient (case 7). He visited to emergency room with lower extremities weakness and voiding difficulty after ESWL treatment for urolithiasis. Sagittal T2- (A) and axial T2-weighted (B) magnetic resonance images of an acute epidural hematoma with maximal compression at the T10-12 level (arrows). T10-L1 total laminectomy was performed. Postoperative sagittal T2-weighted (C) magnetic resonance images show no cord compression. ESWL: extracorporeal shock wave lithotripsy.

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  FIGURE 2. The relationship between surgical timing and neurological outcome. Outcome correlates inversely with the time interval from symptom onset to surgery (Spearman rank correlation coefficient=-0.68, p<0.05).

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  FIGURE 3. The relationship between pre-operative neurological status and post-operative outcome. The postoperative surgical results are correlated with pre-operative neurological status. (Spearman rank correlation coefficient=0.8, p<0.05). JOA: Japanese Orthopaedic Association.

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