title: Diagnosis and microsurgery of symptomatic spontaneous spinal epidural hematoma.
abstract: BACKGROUND
  Symptomatic spontaneous spinal epidural hematoma (SSEH) is an uncommon cause of cord compression that needs emergent treatment. Without effective management of the symptomatic SSEH, irreversible severe spinal injury would be possible.
  
  
  OBJECTIVE
  We aimed to investigate the diagnosis and surgical management of symptomatic SSEH.
  
  
  METHODS
  Five cases of symptomatic SSEH with favorable neurological recovery after emergent microsurgery were prospectively analysed.
  
  
  RESULTS
  The main clinical presentations were root pain and palsy. The main manifestations of MRI were long-segment epidural lesions of high intensity on T1- and T2-weighted images without enhancement. Laminectomy via posterior approach and hematoma removal were undergone for all patients. All patients achieved full neurological recovery without complications.
  
  
  CONCLUSIONS
  MRI manifestation assisted with the main clinical symptoms may aid the preoperative diagnosis of SSEH, and the delay in obtaining preoperative Digital subtraction angiography is worthwhile, especially for those with progressive neurological deterioration.
authors.affiliation: Department of Neurosurgery, Hangzhou Second Hospital, College of Medicine, Hangzhou Normal University, Hangzhou, 310015, China.
authors.forename: W
authors.initials: W
authors.lastname: Qiu
authors.forename: W
authors.initials: W
authors.lastname: Sun
authors.forename: C
authors.initials: C
authors.lastname: Guo
authors.forename: Z
authors.initials: Z
authors.lastname: Wu
authors.forename: M
authors.initials: M
authors.lastname: Ding
authors.forename: H
authors.initials: H
authors.lastname: Shen
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D019299:Decompression, Surgical; D004638:Emergency Treatment; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011379:Prognosis; D013117:Spinal Cord Compression / Q000209:etiology; D055815:Young Adult