J Korean Soc Spine Surg.  2006 Dec;13(4):319-322.

Conservative Treatment of Spontaneous Spinal Epidural Hematoma: A Case Report

• Shim DM
• Jeung UO
• Kim CS

Abstract

A spontaneous spinal epidural hematoma (SSEH) is a rare disease that accompanies severe axial pain in the spine with various levels of paralysis depending on the location of the hematoma. A SSEH is mainly caused by a coagulating disorder or anticoagulants medication, while certain cases relate this disease with spinal inflammatory conditions. The early diagnosis of a SSEH is important for its treatment. Most cases with neurologic symptoms can be treated with a immediate laminectomy and decompression. If the neurologic symptoms improves within 12 hours, a conservative treatment is effective, however few cases have been reported. We encountered a 59 years old male without a prior medical history suffering from severe back pain and paraplegia due to a SSEH at thoracic vertebrae. The patient was successfully treated conservatively. We report this case with a review of the relevant literature.

Keyword

Thoracic vertebrae; Spontaneous spinal epidural hematoma; Conservative treatment

MeSH Terms

Anticoagulants
Back Pain
Decompression
Early Diagnosis
Hematoma
Hematoma, Epidural, Spinal*
Humans
Laminectomy
Male
Middle Aged
Neurologic Manifestations
Paralysis
Paraplegia
Rare Diseases
Spine
Thoracic Vertebrae
Anticoagulants

Figure

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  Fig. 1. (A)T1 weighted sagittal image shows epidural masses at T10, T11, T12 level that have homogenous intermediate signal intensity representing acute hematoma. (B) T2 weighted sagittal image shows epidural masses at T10, T11, T12 level that have heterogenous intermediate signal intensity representing acute hematoma.

• 

  Fig. 2. (A), (B) T2 weighted sagittal & axial images taken at 4 weeks after onset of hematoma show the complete resorption of hematomas.

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