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Journal of the Korean Society of Traumatology 2010;23(2):163-169.
Analysis of the Outcomes of Surgically-Treated Spinal Epidural Hematomas
Young Hyun Cho, Jin Hoon Park, Ji Hoon Kim, Sung Woo Roh, Chang Jin Kim, Sang Ryong Jeon
Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. srjeon@amc.seoul.kr
척추 경막외 출혈에 대한 수술적 치료성적 분석
조영현∙박진훈∙김지훈∙노성우∙김창진∙전상룡
울산대학교 의과대학 서울아산병원 신경외과
Abstract
PURPOSE
Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH.
METHODS
We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively.
RESULTS
Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device.
CONCLUSION
Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.
Key Words: Spinal epidural hematoma; Surgical outcome; Magnetic Resonance Image


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