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A Case of Spontaneous Spinal Epidural Hematoma with Spontaneous Remission before Surgery Hidenori SUZUKI 1 , Yoshisuke YAMAMOTO 1 , Tamotsu HOSHINO 1 , Chikako YONEDA 1 1Department of Neurosurgery, Matsusaka Chuo Sougo Hospital Keyword: Spinal epidural hematoma , MRI , Spontaneous remission , Treatment pp.1119-1123
Published Date 1993/12/10
DOI https://doi.org/10.11477/mf.1436902492
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A 61-year-old man was reterred to our department with spontaneously remitting sensorimotor disturbance and bowel and bladder dysfunctions. He had no specific previous history and neither received any drug nor suffer-ed from hypertension. On onset, complete flaccid paralysis of lower extremities, almost complete sensory disturb-ance of all modalities below the level of Th12, and bowel and bladder dysfunctions were observed. MRI and CT scan revealed an epidural hematoma in the posterior re-gion of the spinal cord at Thll level. Afterwards he con-tinued to improve gradually both clinically and radiologi-cally. Four days subsequent to onset, on admission to our department, he had slight sensorimotor disturbance, and bowel and bladder dysfunctions still existed. MRI de-monstrated a shrinking and flattened hematoma. We per-formed laminectomy and evacuation of the hematoma. Grossly and histologically, no underlying lesion was re-vealed. Postoperative course was not eventful. He was discharged without residual deficits.

In our case, surgery accomplished three goals : defini-tive diagnosis, secure decompression and prevention of recurrence. We believe, the possibility of spontaneous re-solution of spontaneous spinal epidural hematomas (SSEDHs) with spontaneous remission may be high, but prompt surgical evacuation should be the treatment of choice for such cases, even if no underlying lesion is re-vealed by MRI, except in cases where operative morbid-ity and mortality rate is high and in cases with no neuro-logical deficits other than pain. A review of the literature indicated that not all SSEDHs with spontaneous remis-sion resolved spontaneously and completely.


Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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