Emergency surgery in a patient with large spontaneous spinal epidural hematoma determining excellent neurological recovery: review of the literature
Study design: Case report. Objectives: We report a case of a 75-year-old woman suffering from voluminous idiopathic spontaneous spinal epidural hematoma (SSEH) that was rapidly diagnosed and successfully treated. Methods: Clinical presentation was characterized by sudden and intense back pain that r...
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| Veröffentlicht in: | Spinal cord 2014-11, Vol.52 (Suppl 3), p.S22-S24 |
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| creator | Giugno, A Basile, L Maugeri, R Iacopino, D G |
| description | Study design:
Case report.
Objectives:
We report a case of a 75-year-old woman suffering from voluminous idiopathic spontaneous spinal epidural hematoma (SSEH) that was rapidly diagnosed and successfully treated.
Methods:
Clinical presentation was characterized by sudden and intense back pain that rapidly evolved into plegia of the right leg and severe paresis of the left leg. Hypoesthesia below T6 and urinary retention were also present. Magnetic resonance imaging showed a significant posterior spinal compression from T6 through L3 caused by an epidural hematoma that involved 10 metameric levels, extending for ∼20 cm, with a maximum thickness of 1.6 cm from T12 to L1.
Results:
Within 12 h, emergency decompressive laminectomy from T10 to L1 was performed, and evacuation of the hematoma was achieved. The postoperative course and neurological recovery of the patient were optimal. After discharge, the patient continued the rehabilitative treatment started during hospitalization, achieving an excellent functional outcome in 1 month.
Conclusions:
Spinal epidural hematoma (SEH) is a rare clinical finding that can occur following trauma or spontaneously (SSEH). We describe, to the best of our knowledge, the second most extensive idiopathic SSEH and the longest with involvement of the dorso-lumbar spine that had a excellent functional outcome due to emergency decompressive laminectomy, which is emphasized in the treatment of these rare pathologies. |
| doi_str_mv | 10.1038/sc.2014.156 |
| format | Article |
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Case report.
Objectives:
We report a case of a 75-year-old woman suffering from voluminous idiopathic spontaneous spinal epidural hematoma (SSEH) that was rapidly diagnosed and successfully treated.
Methods:
Clinical presentation was characterized by sudden and intense back pain that rapidly evolved into plegia of the right leg and severe paresis of the left leg. Hypoesthesia below T6 and urinary retention were also present. Magnetic resonance imaging showed a significant posterior spinal compression from T6 through L3 caused by an epidural hematoma that involved 10 metameric levels, extending for ∼20 cm, with a maximum thickness of 1.6 cm from T12 to L1.
Results:
Within 12 h, emergency decompressive laminectomy from T10 to L1 was performed, and evacuation of the hematoma was achieved. The postoperative course and neurological recovery of the patient were optimal. After discharge, the patient continued the rehabilitative treatment started during hospitalization, achieving an excellent functional outcome in 1 month.
Conclusions:
Spinal epidural hematoma (SEH) is a rare clinical finding that can occur following trauma or spontaneously (SSEH). We describe, to the best of our knowledge, the second most extensive idiopathic SSEH and the longest with involvement of the dorso-lumbar spine that had a excellent functional outcome due to emergency decompressive laminectomy, which is emphasized in the treatment of these rare pathologies.</description><identifier>ISSN: 1362-4393</identifier><identifier>EISSN: 1476-5624</identifier><identifier>DOI: 10.1038/sc.2014.156</identifier><identifier>PMID: 25376312</identifier><identifier>CODEN: SPCOFM</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/699/375/1824 ; Aged ; Anatomy ; Biomedical and Life Sciences ; Biomedicine ; case-report ; Emergency Treatment ; Female ; Hematoma, Epidural, Spinal - diagnosis ; Hematoma, Epidural, Spinal - surgery ; Human Physiology ; Humans ; Laminectomy - methods ; Neurochemistry ; Neuropsychology ; Neurosciences ; Recovery of Function ; Spinal Neoplasms - diagnosis ; Spinal Neoplasms - surgery ; Thoracic Vertebrae - pathology ; Thoracic Vertebrae - surgery</subject><ispartof>Spinal cord, 2014-11, Vol.52 (Suppl 3), p.S22-S24</ispartof><rights>International Spinal Cord Society 2014</rights><rights>Copyright Nature Publishing Group Nov 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-7af8aafa41621fa9c9ae7b75e8470a95ba76002f25d3a8f333266bd79b6338923</citedby><cites>FETCH-LOGICAL-c424t-7af8aafa41621fa9c9ae7b75e8470a95ba76002f25d3a8f333266bd79b6338923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25376312$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giugno, A</creatorcontrib><creatorcontrib>Basile, L</creatorcontrib><creatorcontrib>Maugeri, R</creatorcontrib><creatorcontrib>Iacopino, D G</creatorcontrib><title>Emergency surgery in a patient with large spontaneous spinal epidural hematoma determining excellent neurological recovery: review of the literature</title><title>Spinal cord</title><addtitle>Spinal Cord</addtitle><addtitle>Spinal Cord</addtitle><description>Study design:
Case report.
Objectives:
We report a case of a 75-year-old woman suffering from voluminous idiopathic spontaneous spinal epidural hematoma (SSEH) that was rapidly diagnosed and successfully treated.
Methods:
Clinical presentation was characterized by sudden and intense back pain that rapidly evolved into plegia of the right leg and severe paresis of the left leg. Hypoesthesia below T6 and urinary retention were also present. Magnetic resonance imaging showed a significant posterior spinal compression from T6 through L3 caused by an epidural hematoma that involved 10 metameric levels, extending for ∼20 cm, with a maximum thickness of 1.6 cm from T12 to L1.
Results:
Within 12 h, emergency decompressive laminectomy from T10 to L1 was performed, and evacuation of the hematoma was achieved. The postoperative course and neurological recovery of the patient were optimal. After discharge, the patient continued the rehabilitative treatment started during hospitalization, achieving an excellent functional outcome in 1 month.
Conclusions:
Spinal epidural hematoma (SEH) is a rare clinical finding that can occur following trauma or spontaneously (SSEH). We describe, to the best of our knowledge, the second most extensive idiopathic SSEH and the longest with involvement of the dorso-lumbar spine that had a excellent functional outcome due to emergency decompressive laminectomy, which is emphasized in the treatment of these rare pathologies.</description><subject>692/699/375/1824</subject><subject>Aged</subject><subject>Anatomy</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>case-report</subject><subject>Emergency Treatment</subject><subject>Female</subject><subject>Hematoma, Epidural, Spinal - diagnosis</subject><subject>Hematoma, Epidural, Spinal - surgery</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Laminectomy - methods</subject><subject>Neurochemistry</subject><subject>Neuropsychology</subject><subject>Neurosciences</subject><subject>Recovery of Function</subject><subject>Spinal Neoplasms - diagnosis</subject><subject>Spinal Neoplasms - surgery</subject><subject>Thoracic Vertebrae - pathology</subject><subject>Thoracic Vertebrae - surgery</subject><issn>1362-4393</issn><issn>1476-5624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkc1u1DAUhSNERX9gxR5ZYoNUMvgnsWN2qCpQqRIbWEc3zs2Mq8QOttMy79EHrsMUhBALVj6SP3_X9imKl4xuGBXNu2g2nLJqw2r5pDhhlZJlLXn1NGcheVkJLY6L0xhvKKWa6eZZccxroaRg_KS4v5wwbNGZPYlLDmFPrCNAZkgWXSJ3Nu3ICHmHxNm7BA79EnO2DkaCs-2XkMMOJ0h-AtJjwjBZZ92W4A-D47haHC7Bj35rTWYDGn-bB73P6dbiHfEDSTsko81HIS0BnxdHA4wRXzyuZ8W3j5dfLz6X118-XV18uC5NxatUKhgagAEqJjkbQBsNqDpVY1MpCrruQElK-cDrXkAzCCG4lF2vdCeFaDQXZ8Wbg3cO_vuCMbWTjeudD69ss1fppqFK_Q_Kaa10LTL6-i_0xi8hf9dPinGpOF-F5wfKBB9jwKGdg50g7FtG27XXNpp27bXNvWb61aNz6Sbsf7O_iszA2wMQ85bLPf4x9B--B0cPrsE</recordid><startdate>20141101</startdate><enddate>20141101</enddate><creator>Giugno, A</creator><creator>Basile, L</creator><creator>Maugeri, R</creator><creator>Iacopino, D G</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20141101</creationdate><title>Emergency surgery in a patient with large spontaneous spinal epidural hematoma determining excellent neurological recovery: review of the literature</title><author>Giugno, A ; Basile, L ; Maugeri, R ; Iacopino, D G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-7af8aafa41621fa9c9ae7b75e8470a95ba76002f25d3a8f333266bd79b6338923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>692/699/375/1824</topic><topic>Aged</topic><topic>Anatomy</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>case-report</topic><topic>Emergency Treatment</topic><topic>Female</topic><topic>Hematoma, Epidural, Spinal - diagnosis</topic><topic>Hematoma, Epidural, Spinal - surgery</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Laminectomy - methods</topic><topic>Neurochemistry</topic><topic>Neuropsychology</topic><topic>Neurosciences</topic><topic>Recovery of Function</topic><topic>Spinal Neoplasms - diagnosis</topic><topic>Spinal Neoplasms - surgery</topic><topic>Thoracic Vertebrae - pathology</topic><topic>Thoracic Vertebrae - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giugno, A</creatorcontrib><creatorcontrib>Basile, L</creatorcontrib><creatorcontrib>Maugeri, R</creatorcontrib><creatorcontrib>Iacopino, D G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Spinal cord</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giugno, A</au><au>Basile, L</au><au>Maugeri, R</au><au>Iacopino, D G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Emergency surgery in a patient with large spontaneous spinal epidural hematoma determining excellent neurological recovery: review of the literature</atitle><jtitle>Spinal cord</jtitle><stitle>Spinal Cord</stitle><addtitle>Spinal Cord</addtitle><date>2014-11-01</date><risdate>2014</risdate><volume>52</volume><issue>Suppl 3</issue><spage>S22</spage><epage>S24</epage><pages>S22-S24</pages><issn>1362-4393</issn><eissn>1476-5624</eissn><coden>SPCOFM</coden><abstract>Study design:
Case report.
Objectives:
We report a case of a 75-year-old woman suffering from voluminous idiopathic spontaneous spinal epidural hematoma (SSEH) that was rapidly diagnosed and successfully treated.
Methods:
Clinical presentation was characterized by sudden and intense back pain that rapidly evolved into plegia of the right leg and severe paresis of the left leg. Hypoesthesia below T6 and urinary retention were also present. Magnetic resonance imaging showed a significant posterior spinal compression from T6 through L3 caused by an epidural hematoma that involved 10 metameric levels, extending for ∼20 cm, with a maximum thickness of 1.6 cm from T12 to L1.
Results:
Within 12 h, emergency decompressive laminectomy from T10 to L1 was performed, and evacuation of the hematoma was achieved. The postoperative course and neurological recovery of the patient were optimal. After discharge, the patient continued the rehabilitative treatment started during hospitalization, achieving an excellent functional outcome in 1 month.
Conclusions:
Spinal epidural hematoma (SEH) is a rare clinical finding that can occur following trauma or spontaneously (SSEH). We describe, to the best of our knowledge, the second most extensive idiopathic SSEH and the longest with involvement of the dorso-lumbar spine that had a excellent functional outcome due to emergency decompressive laminectomy, which is emphasized in the treatment of these rare pathologies.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>25376312</pmid><doi>10.1038/sc.2014.156</doi><oa>free_for_read</oa></addata></record> |
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| subjects | 692/699/375/1824 Aged Anatomy Biomedical and Life Sciences Biomedicine case-report Emergency Treatment Female Hematoma, Epidural, Spinal - diagnosis Hematoma, Epidural, Spinal - surgery Human Physiology Humans Laminectomy - methods Neurochemistry Neuropsychology Neurosciences Recovery of Function Spinal Neoplasms - diagnosis Spinal Neoplasms - surgery Thoracic Vertebrae - pathology Thoracic Vertebrae - surgery |
| title | Emergency surgery in a patient with large spontaneous spinal epidural hematoma determining excellent neurological recovery: review of the literature |
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