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Surgical management of recurrent spontaneous spinal epidural hematoma with 3 episodes.
Spine (Phila Pa 1976). 2015 Sep 01; 40(17):E996-8.S

Abstract

STUDY DESIGN

A case report.

OBJECTIVE

We report a case of spontaneous spinal epidural hematoma with 3 bleeding episodes and discuss the surgical management of recurrent spontaneous spinal epidural hematoma.

SUMMARY OF BACKGROUND DATA

Spontaneous spinal epidural hematoma is a rare condition that causes spinal cord compression and neurological deficits. However, the cause of bleeding remains unclear and recurrent bleeding is very seldom reported.

METHODS

A 39-year-old female patient was referred to Kyoto University hospital with sudden back and right upper extremity pain. She was also treated conservatively at the local hospital 19 and 4 months previously because of same episodes. Magnetic resonance images demonstrated right spinal epidural hematoma at the C6-T1 level. In the first 2 episodes, magnetic resonance images revealed spinal epidural hematomas at exactly the same level.

RESULTS

In the third episode, the patient's neurological condition was not worse than it had been in the first 2 episodes, and we initially managed her conservatively. To identify the cause of the hematoma, surgery was performed 15 days after the third onset. Microscopic examination revealed the development of a venous plexus around the old hematoma in the dorsal epidural space. The patient was discharged without any further neurological deficits, and recurrent bleeding has not occurred for 6 months after surgery.

CONCLUSION

This is the first report of operative and histological observation of recurrent spontaneous spinal epidural hematoma caused by a posterior venous plexus. In a case of recurrent spontaneous spinal epidural hematoma, surgery might be necessary to prevent further hematomas.

LEVEL OF EVIDENCE

N/A.

Authors+Show Affiliations

*Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan, and †Department of Neurosurgery, Otsu Municipal Hospital, Otsu, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26323026

Citation

Yamao, Yukihiro, et al. "Surgical Management of Recurrent Spontaneous Spinal Epidural Hematoma With 3 Episodes." Spine, vol. 40, no. 17, 2015, pp. E996-8.
Yamao Y, Takagi Y, Kawauchi T, et al. Surgical management of recurrent spontaneous spinal epidural hematoma with 3 episodes. Spine (Phila Pa 1976). 2015;40(17):E996-8.
Yamao, Y., Takagi, Y., Kawauchi, T., Arakawa, Y., Takayama, M., & Miyamoto, S. (2015). Surgical management of recurrent spontaneous spinal epidural hematoma with 3 episodes. Spine, 40(17), E996-8. https://doi.org/10.1097/BRS.0000000000001017
Yamao Y, et al. Surgical Management of Recurrent Spontaneous Spinal Epidural Hematoma With 3 Episodes. Spine (Phila Pa 1976). 2015 Sep 1;40(17):E996-8. PubMed PMID: 26323026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical management of recurrent spontaneous spinal epidural hematoma with 3 episodes. AU - Yamao,Yukihiro, AU - Takagi,Yasushi, AU - Kawauchi,Takeshi, AU - Arakawa,Yoshiki, AU - Takayama,Motohiro, AU - Miyamoto,Susumu, PY - 2015/9/1/entrez PY - 2015/9/1/pubmed PY - 2016/8/20/medline SP - E996 EP - 8 JF - Spine JO - Spine (Phila Pa 1976) VL - 40 IS - 17 N2 - STUDY DESIGN: A case report. OBJECTIVE: We report a case of spontaneous spinal epidural hematoma with 3 bleeding episodes and discuss the surgical management of recurrent spontaneous spinal epidural hematoma. SUMMARY OF BACKGROUND DATA: Spontaneous spinal epidural hematoma is a rare condition that causes spinal cord compression and neurological deficits. However, the cause of bleeding remains unclear and recurrent bleeding is very seldom reported. METHODS: A 39-year-old female patient was referred to Kyoto University hospital with sudden back and right upper extremity pain. She was also treated conservatively at the local hospital 19 and 4 months previously because of same episodes. Magnetic resonance images demonstrated right spinal epidural hematoma at the C6-T1 level. In the first 2 episodes, magnetic resonance images revealed spinal epidural hematomas at exactly the same level. RESULTS: In the third episode, the patient's neurological condition was not worse than it had been in the first 2 episodes, and we initially managed her conservatively. To identify the cause of the hematoma, surgery was performed 15 days after the third onset. Microscopic examination revealed the development of a venous plexus around the old hematoma in the dorsal epidural space. The patient was discharged without any further neurological deficits, and recurrent bleeding has not occurred for 6 months after surgery. CONCLUSION: This is the first report of operative and histological observation of recurrent spontaneous spinal epidural hematoma caused by a posterior venous plexus. In a case of recurrent spontaneous spinal epidural hematoma, surgery might be necessary to prevent further hematomas. LEVEL OF EVIDENCE: N/A. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/26323026/Surgical_management_of_recurrent_spontaneous_spinal_epidural_hematoma_with_3_episodes_ DB - PRIME DP - Unbound Medicine ER -