[Evolution of severe pain associated to spontaneous spinal epidural hematoma]

Abstract

Introduction: Spontaneous spinal epidural hematoma is an infrequent disease, whose clinical presentation is very characteristic, with severe pain in region corresponding to the metameres affected, which orients its diagnosis and early treatment.

Clinical cases: Three clinical cases that occurred during 2003 and 2004 are presented. All three were middle- aged men, with spondyloarthrosis signs, posterolateral cervical location of hematoma, which debuted with severe cervical and cervicobrachial pain. This was followed by acute onset motor and sensory paralysis with spontaneous complete recovery in hours, only the pain persisting. The three patients were treated conservatively, pain being the main symptom. This pain only responded to intravenous steroids.

Conclusions: The evolution of the pain and pathophysiological mechanism by which the corticoids could improve the pain associated to these diseases are discussed.