The natural resolution of a lumbar spontaneous epidural hematoma and associated radiculopathy.
This is a report of a 37-year-old man who, while lifting a heavy box, developed severe low-back pain radiating into the right anterior thigh. The only clinical signs were paraspinal muscle spasm and a positive femoral nerve stretch test on the right. An electromyographic study demonstrated denervation in the right L2, L3, and L4 myotomes and paraspinal muscles. Magnetic resonance imaging (MRI) showed a large L1-2 anterior epidural hematoma compressing the spinal cord. The patient's pain gradually improved with conservative management and he returned to light work after 4 weeks. Repeat electromyographic and MRI studies were normal, indicating a resolution of the radiculopathy and hematoma. The diagnosis and management of spontaneous epidural hematomas are discussed.
Kingery
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WS
Department of Functional Restoration, Stanford University Medical School, Palo Alto, CA.
Seibel
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Date
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Marks
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MP
D000328:Adult; D001416:Back Pain / Q000209:etiology; D006407:Hematoma, Epidural, Cranial / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D012075:Remission, Spontaneous; D013117:Spinal Cord Compression / Q000209:etiology / Q000503:physiopathology; D013126:Spinal Nerve Roots