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spinal_epidural_hematoma

Spinal epidural hematoma (SEH)

Spinal epidural hematoma (SEH) is an uncommon entity.

Types

Acute spinal epidural hematoma

Chronic spinal epidural hematoma

Chronic SEHs are rarer than acute SEHs.

Etiology

May be caused by traumatic or nontraumatic conditions that include coagulopathy, vascular lesions and iatrogenic or idiopathic causes.

Yamao et al first reported a operative and histological observation of recurrent spontaneous spinal epidural hematoma caused by a posterior venous plexus 1)

Spinal surgery

Spontaneus

Differential diagnosis

In the presence of an epidural mass with clear clinical symptomatology, rare entities like chronic epidural hematoma or posterior migrated disk material should be always considered as a differential diagnosis in patients with suspicion of extradural chronic compressions. In these cases, only the intraoperatory and histopathological exams can provide a clear diagnosis 2).

Case reports

2016

A 2-year-old boy with a large spinal epidural hematoma resulting after an event of nonaccidental injury, specifically, domestic child abuse. This patient exhibited no focal neurological deficits and was managed conservatively without surgical clot evacuation. On a follow-up visit, repeat imaging studies demonstrated a stable resolution of spinal epidural hematoma, providing further support for the safety of conservative management in these patients 3)

2014

Buvanendran et al. first reported a case of aspirin leading to an epidural hematoma following an interventional chronic pain procedure. Prior to interventional pain procedures, one should contemplate cessation of aspirin therapy because there are, at present, no consensus guidelines to direct such a decision 4).

1)
Yamao Y, Takagi Y, Kawauchi T, Arakawa Y, Takayama M, Miyamoto S. Surgical Management of Recurrent Spontaneous Spinal Epidural Hematoma With 3 Episodes. Spine (Phila Pa 1976). 2015 Sep 1;40(17):E996-E998. PubMed PMID: 26323026.
2)
Iliescu BF, Chiriţă BC, Poeată I. The pitfalls of differential diagnosis of lumbar spine epidural lesions–exemplification with two particular cases and a review of the literature. Rev Med Chir Soc Med Nat Iasi. 2013 Oct-Dec;117(4):947-53. Review. PubMed PMID: 24502074.
3)
Rangwala SD, Birk DM, Tobin MK, Hahn YS, Nikas DC. Spontaneous Resolution of Spinal Epidural Hematoma Resulting from Domestic Child Abuse: Case Report. Pediatr Neurosurg. 2016 Sep 20. [Epub ahead of print] PubMed PMID: 27644085.
4)
Buvanendran A, Young AC. Spinal epidural hematoma after spinal cord stimulator trial lead placement in a patient taking aspirin. Reg Anesth Pain Med. 2014 Jan-Feb;39(1):70-2. doi: 10.1097/AAP.0000000000000029. PubMed PMID: 24310047.
spinal_epidural_hematoma.txt · Last modified: 2016/09/20 16:37 (external edit)