title: Predictors of Outcome in Nontraumatic Spontaneous Acute Spinal Subdural Hematoma: Case Report and Literature Review.
abstract: To analyze the clinical presentation and outcome of nontraumatic spontaneous acute spinal subdural hematoma by observing the predictors of outcome.
  
  
  
  This study was based on a case report and systematic review of the international literature. Among the 151 patients, 80 were female and 65 were male (1.25 female/1.0 male). The age distribution ranged from 6 months to 87 years, with a small increase in incidence between the first and second decade of life and a major peak at age 60 years. The difference of proportion of good results between patients with and without established neurologic deficits was: 0.488, 95% confidence interval (95% CI) 0.237-0.648, P = 2.71e-08; coagulopathy was 0.335, 95% CI 0.163-0.508, P = 0.0002; SAH was 0.0539, 95% CI -0.119 to 0.226, P = 0.6529; lumbar puncture/associated diseases was 0.149 95% CI -0.032 to 0.330, P = 0.1171; surgery was 0.0593, 95% CI -0.114 to 0.233, P = 0.5838; and hematoma extension equal or longer than 5 levels was 0.010 95% CI -0.178 to 0.197, P = 1.
  
  
  
  Although mortality and morbidity associated with nontraumatic spontaneous acute spinal subdural hematoma has decreased during the last 2 decades, the disease still carries a mortality rate of approximately1.3% and a morbidity (permanent neurologic deficits) rate of 28%. The main factors affecting the outcome are neurologic status at presentation and coagulopathies.
authors.affiliation: Centro de Neurologia e Neurocirurgia Associados (CENNA), São Paulo-SP, Brazil; Hospital Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo-SP, Brazil.
authors.forename: Benedito Jamilson A
authors.initials: BJ
authors.lastname: Pereira
authors.affiliation: Divisão de Neurocirurgia Funcional do Hospital das Clínicas da Universidade de São Paulo, São Paulo-SP, Brazil; Hospital Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo-SP, Brazil. Electronic address: antonio.almeida@hc.fm.usp.br.
authors.forename: Antônio Nogueira
authors.initials: AN
authors.lastname: de Almeida
authors.affiliation: Hospital Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo-SP, Brazil.
authors.forename: Valéria Marques F
authors.initials: VM
authors.lastname: Muio
authors.affiliation: Centro de Neurologia e Neurocirurgia Associados (CENNA), São Paulo-SP, Brazil; Hospital Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo-SP, Brazil.
authors.forename: Jean G
authors.initials: JG
authors.lastname: de Oliveira
authors.affiliation: Centro de Neurologia e Neurocirurgia Associados (CENNA), São Paulo-SP, Brazil; Hospital Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo-SP, Brazil.
authors.forename: Carlos Vanderlei Medeiros
authors.initials: CV
authors.lastname: de Holanda
authors.affiliation: Hospital Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo-SP, Brazil.
authors.forename: Nair Cléa
authors.initials: NC
authors.lastname: Fonseca
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D005260:Female; D046649:Hematoma, Subdural, Spinal / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Blood coagulation disorder; Hematoma; Spinal cord compression; Spinal subdural; Surgery