[Non traumatic spinal epidural hematomas. Report of twenty cases. Review of the literature and outcome aspects].
OBJECTIVE
We report a personal series of 20 non traumatic spinal epidural hematomas and study outcome aspects with a review of data in the literature.


METHODS
Clinical presentation of non-traumatic spinal epidural hematomas observed between January 1980 and December 1998 was acute in 17 cases (85%) and chronic in 3 (15%). Symptoms were spinal and/or radicular pain, sensorimotor and sphincter dysfunction. Radiological evaluation consisted in myelography (n=6), myelography-CT scan (n=5), CT scan (n=1) and MRI (n=9). Patients underwent surgery in 15 cases, between 8 hours and 2 months after the first symptoms. All our patients were clinically reevaluated between 2 and 4 months after either surgery or admission for cases of spontaneous resolution.


RESULTS
Good results (complete neurological resolution or moderate sequelae) were observed in 14 patients (70%). A partial recovery with major persistent neurological impairment was observed in 1 patient (5%), an initial persistent neurological impairment in 1 (5%). Three patients (15%) died and 1 (5%) was lost to follow-up. Complete spontaneous resolution were observed in four patients.


CONCLUSIONS
Postsurgical outcome is mainly related to the preoperative neurological impairment, the duration of spinal cord compression and the time interval between the onset of symptoms and maximal deficit. A prompt laminectomy is necessary except in the cases where a spontaneous resolution can be expected from the early neurological course.
Nuti
C
C
Service de Neurochirurgie, Hôpital Bellevue, CHU de Saint-Etienne, boulevard Pasteur, 42055 Saint-Etienne Cedex 2. cnuti@aol.com
Fotso
M-J
MJ
Duthel
R
R
Hatem
O
O
Dumas
B
B
Brunon
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013122:Spinal Diseases / Q000175:diagnosis / Q000601:surgery