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The Necessity of Extensive Decompression for Spinal Epidural Hematoma: A Case Report and Literature Review – Lumbar Spinal Stenosis

This article discusses the case of a 53-year-old man who presented with acute-onset back pain and rapidly progressive paraparesis of both legs. The man was diagnosed with a spinal epidural hematoma (SEH), which is a space-occupying lesion that exerts pressure on the spinal cord due to the accumulation of blood between the dura and bone or ligament components. Immediate decompressive laminectomy and hematoma evacuation were performed, and the patient’s motor function significantly improved within 24 hours. The article highlights the importance of early diagnosis and surgical intervention for SEHs to prevent permanent neurological deficits. PMID: 37641725 | PMC: PMC10460501 | DOI: 10.7759/cureus.44192

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

Spinal epidural hematomas (SEHs)are space-occupying lesions that exert pressure on the spinal cord by rapidly accumulating blood between the dura and bone or ligament components. The annual incidence of spontaneous epidural hematoma is estimated to be one in one million. The predominant symptoms are back pain or neurological impairment, including sensory, motor, or autonomic dysfunction of the limbs below the hematoma level. Depending on the level and size of the hematoma and the affected cord,…

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Cureus. 2023 Aug 27;15(8):e44192. doi: 10.7759/cureus.44192. eCollection 2023 Aug.ABSTRACTSpinal epidural hematomas (SEHs)are space-occupying lesions that exert pressure on the spinal cord by rapidly accumulating blood between the dura and bone or ligament components. The annual incidence of spontaneous epidural hematoma is estimated to be one in one million. The predominant symptoms are back pain or,

Cureus. 2023 Aug 27;15(8):e44192. doi: 10.7759/cureus.44192. eCollection 2023 Aug.

ABSTRACT

Spinal epidural hematomas (SEHs)are space-occupying lesions that exert pressure on the spinal cord by rapidly accumulating blood between the dura and bone or ligament components. The annual incidence of spontaneous epidural hematoma is estimated to be one in one million. The predominant symptoms are back pain or neurological impairment, including sensory, motor, or autonomic dysfunction of the limbs below the hematoma level. Depending on the level and size of the hematoma and the affected cord, they cause neurological deficits. Neurological deficits are often reversible if diagnosed and treated early with surgical decompression. However, neurological deficits can become permanent if the patient is not operated on timely, and paraplegia or quadriplegia may occur. A 53-year-old man presented to our emergency department with acute-onset back pain and 36-hour-long, rapidly progressive paraparesis of both legs. On T1- and T2-weighted MRI scans, a hyperacute SEH was found as iso/hyperintense and hyperintense, respectively. Immediate decompressive laminectomy from T10 to L2 and hematoma evacuation were performed. It was challenging to remove the hematoma due to its firm consistency. Before performing a bilateral total laminectomy at five levels, the posterior spine was stabilized between T10 and L3 using transpedicular screws. Within 24 hours, the motor function of the lower limbs increased considerably. The patient could sit on a chair because of posterior stability. In addition to the importance of early diagnosis using imaging techniques, planning the extension of SEH surgery is crucial for the patient’s postoperative neurological recovery.

PMID:37641725 | PMC:PMC10460501 | DOI:10.7759/cureus.44192

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The Necessity of Extensive Decompression for Spinal Epidural Hematoma: A Case Report and Literature Review

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Cureus. 2023 Aug 27;15(8):e44192. doi: 10.7759/cureus.44192. eCollection 2023 Aug.ABSTRACTSpinal epidural hematomas (SEHs)are space-occupying lesions that exert pressure on the spinal cord by rapidly accumulating blood between the dura and bone or ligament components. The annual incidence of spontaneous epidural hematoma is estimated to be one in one million. The predominant symptoms are back pain or

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