J Korean Soc Spine Surg.  2008 Dec;15(4):272-276. 10.4184/jkss.2008.15.4.272.

Surgical Treatment of Spontaneous Spinal Epidural Hematoma: A Case Report

• Kim MH
• Min SH
• Yoo HY

• KMID: 2209631
• DOI: http://doi.org/10.4184/jkss.2008.15.4.272

Abstract

Spontaneous spinal epidural hematomas without any risk factors, such as spinal tap, trauma, pregnancy, bleeding diathesis, vascular malformations, hypertension, etc. are relatively rare clinical entities. In addition, the clinical suspicion is quite difficult because there are various clinical symptoms according to the size and location of hematoma. However, the speed of diagnosis and initiation of the appropriate treatment are important because the outcome for patients is usually determined by the location and degree of neurological deficits and the duration of dural compression. We report the diagnosis and treatment of spontaneous spinal epidural hematoma in this case with a review of the relevant literature.

Keyword

Thoracolumbar spine; Spontaneous spinal epidural hematoma; Surgical treatment

MeSH Terms

Disease Susceptibility
Hematoma
Hematoma, Epidural, Spinal
Hemorrhage
Humans
Hypertension
Pregnancy
Risk Factors
Spinal Puncture
Vascular Malformations

Figure

• 

  Fig. 1. Sagittal MRI obtained in a 48-year-old mas suffering from sudden onset back pain and sensorimotor paralysis. (A) A T1 weighted image shows epidural masses at T10 to L2 level that have homogeneous intermediated signal intensity representing acute hematoma (yellow arrow). (B) T2-weighted image show epidural masses at T10 to L2 level that have hyperintense with hypointense foci (yellow arrow). (C) T2-weighted image show epidural mass that have hyperintense foci (yellow arrow) and displace thecal sac toward left side (yellow arrow head).

• 

  Fig. 2. Partial hemilaminectomy from T10 to L2 is done at left side. (A) The epidural hematoma was visible under the sublaminar space (yellow arrow) that compressed the dural sac. (B) The epidural hematoma was removed.

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  Fig. 3. Well decompressed cord at postoperatively 2 weeks. Follow-up T1 (A) and T2 (B) weighted images at 2 weeks demonstrate complete resolution of the hematoma and relief of dural compression (yellow arrow).

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