Acute non-traumatic idiopathic spinal subdural hematoma: radiographic findings and surgical outcomes with a literature assessment.
Eur Backbone J. 2017 Nov;26(11):2739-2743
Authors: Kobayashi Okay, Imagama S, Ando Okay, Nishida Y, Ishiguro N
PURPOSE: Intraspinal hematoma is a critical situation, and early analysis is important to allow emergency therapy. Amongst such hematomas, non-traumatic spinal subdural hematoma is a uncommon prevalence. Now we have skilled three sufferers with surgically confirmed subdural spinal hematoma, and right here we report these instances with a assessment of their scientific and imaging traits.
METHODS: All three instances had been idiopathic with no historical past of illness, no coagulopathy, and no trauma. All had acute onset that led to paralysis of the decrease limbs with extreme ache. Early surgical procedure was carried out, based mostly on a comparatively early analysis utilizing thoracolumbar MRI and CT.
RESULTS: Because the epidural fats will not be affected by bleeding, the conventional construction stays and the boundary between hematoma and fats is a major function in MRI and CT. Partial Gd enhancement in MRI and ring enhancement in distinction CT had been additionally obvious. Two of the instances had subarachnoid hematomas.
CONCLUSIONS: Preoperative analysis of spinal subarachnoid hematoma is tough as a result of there are not any particular radiological findings and affirmation can solely happen intraoperatively. Particularly, one case had an enormous hematoma inflicting canal stenosis, and it was tough to differentiate between intradural and extradural hematoma. In all instances of subarachnoid or subdural hematoma, decompression was carried out inside 24 h after onset, and consequently, the sufferers had comparatively good outcomes.
PMID: 28361365 [PubMed – indexed for MEDLINE]