Delayed traumatic spinal epidural hematoma with spontaneous resolution of symptoms

Cuenca, Peter J.; Tulley, Eric B; Devita, Diane; Stone, Allister

doi:10.1016/j.jemermed.2004.02.008

Cited by 44 publications

(29 citation statements)

References 17 publications

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“…14,15 A study conducted in 2013 has stated that subjects presented with extradural hematoma predominantly indicates death with second majority of those who survive but with unfavorable consequences. A very small number is observed to live with favorable outcomes while only few continue to endure life completely.…”

Section: Discussionmentioning

confidence: 99%

Surgical Evacuation Extradural Hematoma under Local Anesthesia

Qureshi¹,

Raja²,

Naim³

et al. 2017

Int. j. endorsing health sci. res.

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Extradural hematoma as a result of traumatic injury is a serious neurological emergency that required immediate intervention. The standard protocol is to identify the condition at earliest and provide quick surgical evacuation of the hematoma. The situation tends to be fatally deteriorating and marks a high mortality rate and worse health outcomes. We have presented a case of extradural hematoma in this study where the surgery had a delay due to the unavailability of general anesthesia. However, the falling Glasgow Coma Scale scores encouraged the surgeons to induce the surgical procedure with the employment of local anesthesia. The intervention turned out to be successful and produced the possibility of using local anesthesia as an alternative in case of critical emergency situations in order to save a life.

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Section: Discussionmentioning

confidence: 99%

Surgical Evacuation Extradural Hematoma under Local Anesthesia

Qureshi¹,

Raja²,

Naim³

et al. 2017

Int. j. endorsing health sci. res.

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“…Traumatic SEHs are less common than spontaneous SEHs, with an incidence estimated at less than 1% to 1.7% of all spinal injuries. 3) Causes of traumatic SEHs include vertebral fractures, obstetric birth trauma, lumbar punctures, bleeding after surgery, epidural anesthesia, and missile injuries. 5) Osteoporotic vertebral collapse is a type of spinal fracture, but is rarely associated with SEHs causing neurologic deficits.…”

Section: Discussionmentioning

confidence: 99%

“…5) Therefore, hematomas located in the thoracic spine are relatively uncommon and are more symptomatic with smaller hematomas because of the thoracic canal anatomy, which is more narrow within the thoracic spine when compared to the cervical or lumbar spine. 3) Furthermore, the symptoms associated with posttraumatic SEHs in the thoracic level are generally present immediately after the incident.…”

Section: Discussionmentioning

confidence: 99%

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Delayed Neurological Deficits Induced by an Epidural Hematoma Associated With a Thoracic Osteoporotic Compression Fracture

Kang

Shin

Lee

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 79-year-old woman developed neurological deficits 6 weeks after the onset of a thoracic osteoporotic compression fracture. Magnetic resonance (MR) imaging of the thoracic spine revealed an epidural hematoma at the T10-L2 levels. Acute decompressive laminectomy and percutaneous vertebroplasty were performed. Following the surgery, the patient's neurologic deficits improved and follow-up MR imaging showed complete resolution of the hematoma. Spinal epidural hematomas are rare and associated delayed neurological deficits are extremely rare. Conservative treatment may be effective for epidural hematomas in neurologically intact patients, but epidural hematomas can be a cause of neural compression and symptomatic deterioration resulting in delayed neurological deficits during the follow-up period

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“…The delayed neurologic symptoms are consistent with previously reported cases of TSEH in which cord compression does not manifest itself until some time (7 days to 2.5 months) after the initial injury. 6,7 In a review of high-pressure injection injuries of a foreign material into the body, the cause of delayed symptoms is described as arising from the combination of the additional volume and evolving inflammatory response because of the presence of a foreign substance. 8 These factors may help account for the delayed onset of symptoms in our patient.…”

Section: Discussionmentioning

confidence: 99%

Spinal Epidural Lubricant Grease Collection Mimicking Traumatic Spinal Epidural Hematoma

Kalnins¹,

Geryk²,

Olivero³

et al. 2009

AJNR Am J Neuroradiol

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SUMMARY:We report an unusual case of a patient with an epidural fluid collection with signal characteristics mimicking an epidural hematoma. The patient presented with myelopathy caused by thoracic spinal cord compression after a traumatic injury to the chest and back. The injury was caused by high-pressure injection of industrial-grade lubricant grease. This case demonstrates that cord compression can be caused by exogenous material in the setting of trauma that can mimic an acute epidural hematoma.

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Delayed traumatic spinal epidural hematoma with spontaneous resolution of symptoms

Cited by 44 publications

References 17 publications

Surgical Evacuation Extradural Hematoma under Local Anesthesia

Surgical Evacuation Extradural Hematoma under Local Anesthesia

Delayed Neurological Deficits Induced by an Epidural Hematoma Associated With a Thoracic Osteoporotic Compression Fracture

Spinal Epidural Lubricant Grease Collection Mimicking Traumatic Spinal Epidural Hematoma

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