Journal List > J Korean Soc Spine Surg > v.13(4) > 1035735

Shim, Jeung, and Kim: Conservative Treatment of Spontaneous Spinal Epidural Hematoma - A Case Report -

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 anticoag-ulants 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.

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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.
jkss-13-319f1.tif
Fig. 2.
(A), (B) T2 weighted sagittal & axial images taken at 4 weeks after onset of hematoma show the complete resorption of hematomas.
jkss-13-319f2.tif
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