Acute spinal intradural extramedullary hematoma

Schwerdtfeger, Karsten; Caspar, W.; Alloussi, Schanas; Strowitzkí, Martin; Loew, F.

doi:10.1097/00006123-199008000-00026

Cited by 10 publications

(1 citation statement)

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“…In conclusion, although emergent surgical decompression is mandatory in most cases of spinal subdural hematoma, conservative management with the steroid infusion could be an option for patients presenting mild neurological deficits, early progressive improvement, and poor general condition 12,20…”

Section: Discussionmentioning

confidence: 99%

Treatment of Spontaneous Cervical Spinal Subdural Hematoma with Methylprednisolone Pulse Therapy

et al. 2011

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We report herein a case of hyperacute onset of spontaneous cervical spinal subdural hematoma treated with methylprednisolone pulse therapy that showed good results. A 57-year-old man was admitted for posterior neck pain and paraparesis which occurred an hour ago. MRI revealed a ventral subdural hematoma distributed from the level of C1 down to T3, compressing the spinal cord. Conservative management with methylprednisolone pulse therapy was administered considering the patient's poor general condition. Although emergent surgical decompression is necessary in most cases of spinal subdural hematoma, conservative management with steroid therapy could be effective.

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Section: Discussionmentioning

confidence: 99%

Treatment of Spontaneous Cervical Spinal Subdural Hematoma with Methylprednisolone Pulse Therapy

et al. 2011

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Spinal epidural haematoma: report of 11 cases and review of the literature

et al. 1994

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Spinal epidural haematomas (SEH) are rare; most are caused by trauma, anticoagulant therapy, vascular anomalies, hypertension, blood dyscrasias, epidural anaesthesia or, rarely, spinal surgery. We report 11 cases and review the literature (16 cases). The clinical picture is that of acute spinal cord compression. MRI characteristics are quite specific. On sagittal sections, the SEH appears as a biconvex mass, dorsal to the thecal sac, clearly outlined and with tapering superior and inferior margins. The dura mater is seen as curvilinear low signal separating the haematoma from the cord. Within 24 h of onset, the haematoma is isointense with the cord on T1-weighted images and heterogeneous on T2-weighted images. Later, it gives high signal on both T1- and T2-weighted images. Differential diagnosis must include subdural haematoma, epidural neoplasm and abscess. Complete neurological recovery rapidly follows laminectomy and removal of the clot. In three of our cases, the haematoma resolved spontaneously. MRI is the best examination for diagnostic and follow-up.

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Percutaneous drainage of a postoperative intraspinal hematoma using a Tuohy needle

2003

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A 78-year-old man developed a large subdural hematoma extending from T12 to L3 levels following L3 laminectomy and L3-5 posterior spinal fusion. He had associated neurological signs and symptoms. MR imaging showed typical signal characteristics of a subacute intraspinal subdural hematoma. Percutaneous drainage was successfully performed under CT guidance by inserting a Tuohy needle through the L3 laminectomy defect. The catheter packaged with the Tuohy needle was inserted cranially into the hematoma and 30 ml of blood was aspirated. Follow-up MR imaging confirmed resolution of the hematoma and the patient made a rapid recovery.

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Acute spinal intradural extramedullary hematoma

Cited by 10 publications

References 0 publications

Treatment of Spontaneous Cervical Spinal Subdural Hematoma with Methylprednisolone Pulse Therapy

Treatment of Spontaneous Cervical Spinal Subdural Hematoma with Methylprednisolone Pulse Therapy

Spinal epidural haematoma: report of 11 cases and review of the literature

Percutaneous drainage of a postoperative intraspinal hematoma using a Tuohy needle

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