Case Series of Spinal Epidural Hematoma: A Single Center Experience

Background and Importance: Spinal epidural hematoma (EDH) is a rare clinical condition that occurs spontaneously in patients with a spine injury. Most patients require laminectomy and evacuation of spinal EDH. Magnetic resonance imaging (MRI) of the spine with magnetic resonance angiography is the chosen radiological investigation. This study aims to review cases with spinal EDH and discuss its etiology, pathogenesis, investigations, and various management strategies. Case Presantation: This is a retrospective analysis study of five spinal EDH cases admitted at our institute from August 2020 to August 2021. Four patients underwent laminectomy and evacuation, while one was managed conservatively because of rapid clinical improvement. The patients’ functional outcomes were assessed by using American spinal cord injury association impairment scale (AIS) before and after treatment. Four of the five patients who participated in this study had significant neurological improvement. One of the patients who presented late to us had poor neurological recovery despite the surgical intervention. Conclusion: Surgical evacuation of spinal EDH within 48 hours of the onset of symptoms ensures good clinical recovery. Spontaneous resolution is possible in some cases if patients have an improvement in their neurological status early in the course of the disease. Hence, we conclude that prompt treatment in spinal EDH patients ensures maximum functional recovery. Patients with spinal EDH need close follow-up and periodical neurological examination.