A case of nontraumatic spinal epidural hematoma caused by extradural varix: consideration of etiology.
BACKGROUND
Many cases of nontraumatic spinal epidural hematoma (SEH) have been reported, although the etiology of SEH remains unclear.


OBJECTIVE
Our purpose was to report a rare case of nontraumatic acute SEH caused by extradural varices and to discuss the etiology of this entity.


METHODS
Case report.


METHODS
A 27-year-old man.


METHODS
Resolution of the patient's paraplegia, and pathological examination of the epidural vein of the patient and three other patients with cervical spondylosis.


METHODS
Not applicable.


RESULTS
The patient recovered from paresis of both hands, although paraplegia remains complete. Pathological examination of the patient revealed abnormal veins that had thickened walls, varying caliber, and internal elastic lamina. In two of the three patients with cervical spondylosis, abnormally dilated veins resembling those in the SEH patient were observed.


CONCLUSIONS
We describe a rare case of SEH caused by extradural varices. It is speculated that spinal epidural veins can possibly develop an abnormal structure and fragility as seen in the present case and in spondylotic cases.
Akutsu
Hiroyoshi
H
Department of Neurosurgery, Mito National Hospital, Ibaraki, Japan. akutsuh@zf6.so-net.ne.jp
Sugita
Kyoichi
K
Sonobe
Makoto
M
Matsumura
Akira
A
D000328:Adult; D000792:Angiography; D001707:Biopsy, Needle; D002574:Cervical Vertebrae; D004824:Epidural Space; D005500:Follow-Up Studies; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006407:Hematoma, Epidural, Cranial; D006801:Humans; D007150:Immunohistochemistry; D007796:Laminectomy / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D020127:Recovery of Function; D018570:Risk Assessment; D013116:Spinal Cord / Q000098:blood supply*; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome; D014648:Varicose Veins / Q000150:complications*