Spontaneous spinal epidural hematoma: The importance of preoperative neurological status and rapid intervention

Rajz, Gustavo; Cohen, José E.; Harnof, Sagi; Knoller, Nachshon; Goren, Oded; Shoshan, Yigal; Fraifeld, Shifra; Kaplan, Leon; Itshayek, Eyal

doi:10.1016/j.jocn.2014.07.003

Cited by 43 publications

(47 citation statements)

References 33 publications

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“…But most often, surgical decompression of the neural structures and removal of the hematoma is necessary [9]. Outcome is mainly determined by the preoperative neurological status [11,12] and the use of anticoagulants [11]. The interval from symptom onset to surgery doesn't seem to be a primary factor in determining prognosis [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Outcome is mainly determined by the preoperative neurological status [11,12] and the use of anticoagulants [11]. The interval from symptom onset to surgery doesn't seem to be a primary factor in determining prognosis [11,12]. However, urgent surgical decompression is still recommended in all symptomatic patients [12].…”

Section: Discussionmentioning

confidence: 99%

“…The interval from symptom onset to surgery doesn't seem to be a primary factor in determining prognosis [11,12]. However, urgent surgical decompression is still recommended in all symptomatic patients [12]. In those with incomplete cord injury this is even of greater importance, since they have the best chances to regain full neurological function [12].…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous spinal epidural hematoma in two toddlers: diagnostic pitfalls

Smeets¹,

Akker²,

Peters³

et al. 2016

Pediatr Dimensions

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We report two boys with a spontaneous spinal epidural hematoma (SSEH). The first child presented at the age of 2 years with back pain and general weakness after a respiratory tract infection. After a first surgical intervention he developed a recurrence of bleeding, necessitating re-intervention. He developed medullary ischemia. Important neurologic deficits with paresis of the lower extremities and bladder dysfunction persisted. The other child presented at the age of 1,5 years with irritability and crying, attributed to a mesenteric lymphadenitis. He underwent a laminectomy with drainage of the hematoma. The postoperative course was uneventful. In both cases, no identifiable cause was found for the bleeding. SSEH is a rare condition, but represents a medical emergency. In most pediatric cases, presentation is atypical with back or neck pain and general irritability as sole initial symptom. Neurologic focal signs can arise hours or days after the onset of the bleeding. Knowledge of SSEH presenting signs and symptoms is important for timely diagnosis and treatment. Although it is mostly a solitary event, we stress the importance of close clinical, and if necessary radiological, follow up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous spinal epidural hematoma in two toddlers: diagnostic pitfalls

Smeets¹,

Akker²,

Peters³

et al. 2016

Pediatr Dimensions

View full text Add to dashboard Cite

show abstract

“…Sudden, intense neck/back pain followed by motor and sensory deficits in the subsequent hours are the usual symptoms of SSEH [1,3,20,21]. In some cases sphincter disorders may develop [22].…”

Section: Discussionmentioning

confidence: 99%