Diagnosis and microsurgery of symptomatic spontaneous spinal epidural hematoma.

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.

OBJECTIVES

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.