Delayed traumatic thoracic spinal epidural hematoma: a case report and literature review.
Spinal epidural hematoma is a relatively uncommon disease, but an important cause leading to cord compression. Posttraumatic spinal epidural hematoma is a rare entity and remains a challenge for clinical physicians. Magnetic resonance imaging is the best choice for early diagnosis, and urgent surgical decompression with evacuation of hematoma could improve some neurologic deficits, especially vital cord functions. We presented a 77-year-old woman who sustained back pain after a fall 1 month before admission, complaining of progressive weakness and sensory loss in bilateral lower extremities since 2 weeks before admission. Radiography of the thoracic spine revealed decreased body height at T10 and compression fracture. Magnetic resonance imaging of the thoracic spine revealed epidural hematomas at the level of T11 to T12. An urgent decompressive laminectomy with evacuation of hematoma was performed immediately. Postoperatively, her previous neurologic deficits improved except for an underactive neurogenic bladder and fecal incontinence.
Hsieh
Cheng-Ta
CT
Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chiang
Yung-Hsiao
YH
Tang
Chi-Tun
CT
Sun
Jui-Ming
JM
Ju
Da-Tong
DT
D000368:Aged; D019299:Decompression, Surgical; D005260:Female; D050815:Fractures, Compression / Q000000981:diagnostic imaging* / Q000209:etiology; D046748:Hematoma, Epidural, Spinal / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications; D011859:Radiography