Department of Neurosurgery, Hangzhou Second Hospital, College of Medicine, Hangzhou Normal University, Hangzhou, 310015, China.
Ir J Med Sci. 2011 Mar;180(1):241-5. doi: 10.1007/s11845-010-0533-z. Epub 2010 Aug 3.
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.
We aimed to investigate the diagnosis and surgical management of symptomatic SSEH.
Five cases of symptomatic SSEH with favorable neurological recovery after emergent microsurgery were prospectively analysed.
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.
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.
症状性自发性硬脊膜外血肿（SSEH）是引起脊髓压迫的一种不常见原因，需要紧急治疗。如果不对症状性 SSEH 进行有效治疗，可能会导致不可逆转的严重脊髓损伤。
我们旨在研究症状性 SSEH 的诊断和手术治疗。
前瞻性分析了 5 例经急症显微镜手术治疗后神经功能恢复良好的症状性 SSEH 患者。
主要的临床表现为神经根痛和瘫痪。MRI 的主要表现为 T1 加权像和 T2 加权像上呈高强度的长节段硬脊膜外病变，无强化。所有患者均行后路椎板切除术和血肿清除术。所有患者均完全恢复神经功能，无并发症发生。
MRI 表现结合主要的临床症状有助于 SSEH 的术前诊断，延迟获得术前数字减影血管造影是值得的，特别是对于那些神经功能进行性恶化的患者。
