Journal List > J Korean Soc Spine Surg > v.15(3) > 1035813

Jeong, Kim, and Nam: Spontaneous Spinal Epidural Hematoma of the Thoracic Spine in Young Adult


A spontaneous spinal epidural hematoma (SSEH) of the thoracic spine is a rare space-occupying disease that accompanied with severe axial pain in the spine. Because there is the possibility of a significant neurological injury such as paraplegia, SSEH requires careful diagnosis and management. A SSEH is mainly caused by a coagulating disorder or anticoagulant medication, while certain cases have shown that this disease is related with spinal inflammatory conditions. A SSEH tends to occur in patients who have risk factors for hemorrhage. However, the incidence of SSEH is quite low, and there are few domestic reports of a SSEH in young adults who are without the risk factors for hemorrhage. We encountered a 25 years old young male without a prior significant medical history and he was suffering from severe back pain and paraplegia due to a SSEH at the thoracic spine. The early diagnosis was made via MRI. We report here on a favorable clinical outcome that was achieved with immediate operative treatment, and we include a review of the relevant literature.


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Fig. 1.
(A, B) T1 and T2-weighted sagittal image demonstrates fusiform-shaped hematoma in the spinal canal, (C) sagittal image after Gadolinium-DTPA injection shows poorly enhanced hematoma filled the spinal canal, extending from T7-T9. (D) T2 weighted axial image demonstrates spinal cord-compressing hematoma with high and intermediated signal intensity at posterior aspect of spinal cord. (E) T1 weighted enhanced axial image shows poorly enhanced mass-like lesions.
Fig. 2.
The x-rays at 2 year 6 months follow-up show no kyphosis and spinal instability (arrow: laminectomy site).
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