Spontaneous Acute Spinal Epidural Hematoma : Three Cases Report

Abstract

Spontaneous spinal epidural hematoma is uncommon ， The classical clinical presentation is acute onset of severe irradiating back pain ， followed by the signs and symptolns of a rapidly evolving spinal cord compression ． Early diagnosis fbllowed by immediate treatment of the cases mentioned here achieved good P 「ognoses ． We describe three cases of spontaneous acute spinal epidural hematoma ． All cases were diagnosed by magnetic resonance imaging (MRI)and treated by decompressive surgery as soon as possible， and all patients showed good postoperative recovery ． We also review 123 cases of spontaneous acute spinal epidural hematoma previously reported in the literature ． Key word ： spinal epiduraI hematoma ， spontaneous ， MRI ， early treatment Spina 且 Sllrgery 14 (2)：117-124 ， 2000

An Elderly Patient who Developed Spontaneous Spinal Epidural Hematoma during Warfarin Therapy

“…Acute disc herniation, spinal tumor, spinal tuberculosis, intradural or extradural tumors, pyogenic spondylitis, and extradural abscess are considered in the differential diagnosis, and most of these conditions can be differentiated from SSEH on the basis of their MRI features. The MR images of the epidural hematoma in the present patient revealed an isointense lesion on T1-weighted images and a lesion with heterogeneous intensity on T2-weighted images; these findings were consistent with those of SSEH in the subacute phase reported to date (6).…”

“…For patients with incomplete dysfunction of the spinal cord, favorable outcomes are highly correlated with surgical treatments within 48 hours (7). Severe neurologic symptoms, high levels of spinal cord dysfunction, and old age are the factors responsible for adverse outcomes (6). Spontaneous improvements are reported in patients with a lower magnitude of paralysis (more than MMT 3) and neurological recovery occurring at an early stage (less than 24 hours) after hemorrhage (8,9).…”