[Diagnosis and treatment of spontaneous spinal epidural hematoma]

Abstract

Objective: To evaluate the cause of hemorrhage of spontaneous spinal epidural hematoma (SSEH), its clinical manifestations, MR images, treatment, and prognosis.

Methods: Based on literature review, we retrospectively analysed 6 patients with SSEH in terms of pathogenic mechanism, clinical features, neurological function, and the interval between the onset of SSEH and surgery and prognosis.

Results: SSEH was liable to occur in young people, and most of cases were acute. MR imaging showed semilunar space occupying mass in the posterior or posteriolateral part inside the spinal canal. The outcome was closely related to the interval between the onset and surgery, whereas it was not related to age, site and size of the hematoma. The better neurological state before surgery and the shorter interval between onset and operation, the better outcome in such patients.

Conclusions: SSEH may be originated from venous bleeding. The process at onset and clinical manifestation depends on the blood supply of the spinal cord. The optimal diagnostic method is MR imaging. Decompression of spinal cord in time is the key procedure for improving the patients' outcome.