Two Patients with Spontaneous Spinal Epidural Hematoma Carrying a Good Prognosis without Surgical Operations

• Main Authors: Katsuhiko Ogawa (Author), Takayoshi Akimoto (Author), Makoto Hara (Author), Midori Fujishiro (Author), Hiroshi Uei (Author), Hideto Nakajima (Author)
• Format: Book
• Published: MDPI AG, 2023-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/neurolint15010024; 2035-8377
• Keywords: acute onset; back pain; CT; MRI; myelopathy; radiculopathy; Medicine; R; Internal medicine; RC31-1245; Neurosciences. Biological psychiatry. Neuropsychiatry; RC321-571; Neurosciences. Biological psychiatry. Neuropsychiatry; RC321-571
• Source: Neurology International, Vol 15, Iss 1, Pp 362-370 (2023)

(1) Introduction: Spontaneous spinal epidural hematoma (SSEH) points to hematoma within the epidural space of the spinal cord without traumatic or iatrogenic causes. (2) Case Reports: One patient showed paraplegia, numbness of both legs with acute onset, acute myelopathic signs, subsequent to back pain. Magnetic resonance imaging (MRI) showed hematoma in the posterior part of the thoracic spinal cord. Another patient showed acute numbness in the shoulder, upper part of the back, and the upper extremity on the right side after pain in the back, shoulder, and neck on the right side. Sagittal computed tomography (CT) images of the cervical bone showed a high-density area behind the spinal cord between C4 and C7. MRI analysis showed hematoma in the right diagonally posterior part of the cervical spinal cord. These 2 patients lacked traumatic or iatrogenic events, and their symptoms abated without surgical operation. (3) Conclusions: The location of hematoma correlated with symptoms in each patient. SSEH is rare but should be taken into account in patients with myelopathy or radiculopathy with acute onset subsequent to back pain. The usefulness of emergent CT scans of the spinal cord prior to MRI analysis was shown in the diagnosis of SSEH.