Spontaneous spinal epidural hematoma of unknown etiology: case report and literature review.
BACKGROUND
Our objective is to emphasize the importance of recognizing and rapidly treating spontaneous spinal epidural hematoma (SSEH). SSEH is a pathologic entity traditionally thought to be exceptionally rare but which, in the era of MR imaging, is becoming increasingly prevalent, and which if treated with sufficient rapidity can be completely curable.


METHODS
Our particular case presented with clumsiness, neck pain with radiation to both arms, and bilateral arm weakness. According to the literature surveyed, most patients present with severe back and/or neck pain, often with a radicular component, followed by motor and/or sensory deficits.


METHODS
C5-6 decompressive hemilaminectomy with evacuation of hematoma.


CONCLUSIONS
As evidenced in the literature, outcome depends on time to operation and prognosis is impacted by age and preoperative deficit. Because of the high risk of poor outcome without treatment, SSEH should always be a diagnostic consideration in patients whose presentation is even slightly suggestive. Rapid, appropriate treatment of these patients can often lead to complete recovery of function, whereas any delay in appropriate treatment can be catastrophic.
Thiele
Robert H
RH
Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
Hage
Ziad A
ZA
Surdell
Daniel L
DL
Ondra
Stephen L
SL
Batjer
H Hunt
HH
Bendok
Bernard R
BR
D019299:Decompression, Surgical; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged