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J Korean Soc Emerg Med > Volume 15(3); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(3): 197-200.
Acute Spontaneous Thoracic Spinal Epidural Hematoma: A Case Report
Nam Kyu Kang, Hoon Pyo Hong, Myung Chun Kim, Young Gwan Ko
Department of Emergency Medicine, College of Medicine, Kyung Hee University, Seoul, Korea. edkmc@chollian.net
ABSTRACT
Spontaneous spinal epidural hematoma (SSEH) is a rare entity that has been reported to occur in different age groups, from pediatric to elderly patients. The etiology and the pathogenesis remain unclear. By definition, SSEH excludes that due to obvious trauma, anticoagulant therapy, coagulopathy, vascular malformation, and tumors. The pre-senting symptoms vary, but the usual earliest presentation is a sudden stabbing pain associated with a nerve-root type of irradiation. A variable degree of sensorimotor deficit then rapidly develops. An urgent computed tomography (CT) myelography and magnetic resonance imaging (MRI) can be performed to diagnose the hematoma. For patients with incomplete sensorimotor deficit, favorable outcomes are thought to correlate highly with surgery (decompressive laminectomy) within 48 hours. This critical time is sharply reduced to 12 hours for patients with complete sensorimotor deficit.
Key words: Epidural hematoma, Laminectomy, Spine
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