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Spontaneous spinal epidural hematoma leading to acute paraplegia: a case report – Lumbar Spinal Stenosis

This article discusses a case of spontaneous spinal epidural hematoma, a rare condition characterized by the accumulation of blood in the epidural space. The case involves a 58-year-old woman with well-controlled hypertension, hyperlipidemia, type II diabetes mellitus, and microscopic hematuria. She presented to the emergency department with sudden-onset back pain, weakness, and numbness in both lower limbs. Imaging revealed a spinal epidural hematoma from thoracic 9 to lumbar 1. Prompt decompressive surgery was performed, and the patient is currently undergoing postoperative rehabilitation for paralysis. The article emphasizes the severity and life-altering consequences of this condition and highlights the need for swift evaluation and surgical intervention in cases of acute paraplegia

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSION: This case emphasizes the severity and life-altering consequences of spontaneous spinal epidural hematomas. Despite various proposed causative factors, a definitive consensus remains elusive in current literature. Consequently, maintaining a low threshold of suspicion for patients with similar presentations is crucial. The findings underscore the urgent need for swift evaluation and surgical intervention in cases of acute paraplegia.

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J Med Case Rep. 2023 Dec 14;17(1):545. doi: 10.1186/s13256-023-04297-y.ABSTRACTBACKGROUND: Spontaneous spinal epidural hematoma is an infrequent yet potentially debilitating condition characterized by blood accumulation in the epidural space, with only 300 documented cases globally. Although the exact etiology of spontaneous spinal epidural hematoma remains poorly understood, theories suggest arteriovenous malformations, rupture of epidural vessels, or,

J Med Case Rep. 2023 Dec 14;17(1):545. doi: 10.1186/s13256-023-04297-y.

ABSTRACT

BACKGROUND: Spontaneous spinal epidural hematoma is an infrequent yet potentially debilitating condition characterized by blood accumulation in the epidural space, with only 300 documented cases globally. Although the exact etiology of spontaneous spinal epidural hematoma remains poorly understood, theories suggest arteriovenous malformations, rupture of epidural vessels, or epidural veins as possible causes.

CASE PRESENTATION: This study presents a 58-year-old Malay woman patient from Singapore with well-controlled hypertension, hyperlipidemia, type II diabetes mellitus, and microscopic hematuria. Despite a prior cystoscopy revealing no abnormalities, she presented to the emergency department with sudden-onset back pain, weakness, and numbness in both lower limbs. Rapidly progressing symptoms prompted imaging, leading to the diagnosis of a spinal epidural hematoma from thoracic (T) 9 to lumbar (L) 1. Prompt decompressive surgery was performed, and the patient is currently undergoing postoperative rehabilitation for paralysis.

CONCLUSION: This case emphasizes the severity and life-altering consequences of spontaneous spinal epidural hematomas. Despite various proposed causative factors, a definitive consensus remains elusive in current literature. Consequently, maintaining a low threshold of suspicion for patients with similar presentations is crucial. The findings underscore the urgent need for swift evaluation and surgical intervention in cases of acute paraplegia.

PMID:38093265 | DOI:10.1186/s13256-023-04297-y

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Spontaneous spinal epidural hematoma leading to acute paraplegia: a case report

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J Med Case Rep. 2023 Dec 14;17(1):545. doi: 10.1186/s13256-023-04297-y.ABSTRACTBACKGROUND: Spontaneous spinal epidural hematoma is an infrequent yet potentially debilitating condition characterized by blood accumulation in the epidural space, with only 300 documented cases globally. Although the exact etiology of spontaneous spinal epidural hematoma remains poorly understood, theories suggest arteriovenous malformations, rupture of epidural vessels, or

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