Epidural Hematoma in the Thoracic Spine Causing Myelopathy. Report of Two Cases Toshitaka Naganawa 1 , Seiichi Sugiyama 1 , Ei Wakabayashi 1 , Kazuhiko Wakahara 1 , Hideo Hosoe 1 , Katsuji Shimizu 1 , Akira Hioki 2 1Department of Orthopaedic Surgery,Gifu University School of Medicine 2Department of Orthopaedic Surgery,Gero Hot Spring Hospital Keyword: spinal epidural hematoma(脊椎硬膜外血腫) , thoracic spine(胸椎) , therapy(治療) pp.307-311
Published Date 2005/3/1
DOI https://doi.org/10.11477/mf.1408100070
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We report two cases of epidural hematoma in the thoracic spine. Patient 1 was a 49-year-old female who experienced the sudden onset of back pain and paraplegia(Frankel E). MRI revealed a posterior epidural mass between T1 and T2,and it was diagnosed as a thoracic epidural hematoma. The epidural hematoma was removed surgically and the symptoms resolved immediately postoperatively. Patient 2 was a 72-year-old man with a chief complaint of abdominal pain. The initial diagnosis was paralytic ileus,but paraplegia developed three hours later(Frankel B)and MRI demonstrated a posterior epidural mass extending from T9 to T11 that was compressing the spinal cord. Both the paralytic ileus and paraplegia resolved completely in response to conservative treatment(Frankel E). The epidural spinal hematoma in patients with spinal epidural hematoma and persistent paraplegia should be surgically removed as soom as possible. However,conservative treatment should be considered in patients who spontaneouly recover from the paraplegia within 24 hours.

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