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Acute idiopathic spinal subdural hematoma: What to do in an emergency?
Neurochirurgie. 2019 Apr - Jun; 65(2-3):93-97.N

Abstract

Acute spinal cord compression usually results from trauma, infection, or cancer. Spinal subdural hematoma is an uncommon cause of spinal cord compression that occurs after spine trauma or spinal invasive procedure, especially in context of coagulopathy. In the following reported case, an 82-year-old woman with a history of rapidly progressive paraparesis after a sudden middle back pain, with no previous trauma or coagulopathy, due to an acute spontaneous spinal subdural hematoma. In fact, the main difficulty was to determine, in an emergency situation, the right strategy to identify both the lesion and its cause to adapt therapeutics. This case not only provides an illustrative unusual condition in an emergency department but also a challenging discussion to choose the right treatment for a sudden neurological impairment. According to a literature review of the idiopathic cases of spinal subdural hematomas without coagulopathy, the clinical outcome depends on severity of neurological impairment. MRI is the main examination to perform in an emergency. Thus surgical evacuation should be performed in emergency in patients presenting with severe neurological impairment.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Joubert C
Department of neurosurgery, Sainte Anne Military Hospital, France. Electronic address: christophe.joubert@neurochirurgie.fr.
Gazzola S
Department of neurosurgery, Sainte Anne Military Hospital, France; Department of Interventional Radiology, Sainte Anne Military Hospital, France. Electronic address: sebastien.gazzola@gmail.com.
Sellier A
Department of neurosurgery, Sainte Anne Military Hospital, France. Electronic address: aurore.sellier@live.fr.
Dagain A
Department of neurosurgery, Sainte Anne Military Hospital, France. Electronic address: dr.adagain@gmail.com.

MeSH

Aged, 80 and overBack PainEmergency Medical ServicesFemaleHematoma, Subdural, SpinalHumansMagnetic Resonance ImagingParaparesisSpinal Cord CompressionTreatment Outcome

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30744959

Citation

Joubert, C, et al. "Acute Idiopathic Spinal Subdural Hematoma: what to Do in an Emergency?" Neuro-Chirurgie, vol. 65, no. 2-3, 2019, pp. 93-97.
Joubert C, Gazzola S, Sellier A, et al. Acute idiopathic spinal subdural hematoma: What to do in an emergency? Neurochirurgie. 2019;65(2-3):93-97.
Joubert, C., Gazzola, S., Sellier, A., & Dagain, A. (2019). Acute idiopathic spinal subdural hematoma: What to do in an emergency? Neuro-Chirurgie, 65(2-3), 93-97. https://doi.org/10.1016/j.neuchi.2018.10.009
Joubert C, et al. Acute Idiopathic Spinal Subdural Hematoma: what to Do in an Emergency. Neurochirurgie. 2019 Apr - Jun;65(2-3):93-97. PubMed PMID: 30744959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute idiopathic spinal subdural hematoma: What to do in an emergency? AU - Joubert,C, AU - Gazzola,S, AU - Sellier,A, AU - Dagain,A, Y1 - 2019/02/08/ PY - 2018/03/11/received PY - 2018/08/16/revised PY - 2018/10/06/accepted PY - 2019/2/13/pubmed PY - 2019/11/23/medline PY - 2019/2/13/entrez KW - Acute paraparesis KW - Angiography KW - Idiopathic spinal subdural hematoma KW - Spinal MRI SP - 93 EP - 97 JF - Neuro-Chirurgie JO - Neurochirurgie VL - 65 IS - 2-3 N2 - Acute spinal cord compression usually results from trauma, infection, or cancer. Spinal subdural hematoma is an uncommon cause of spinal cord compression that occurs after spine trauma or spinal invasive procedure, especially in context of coagulopathy. In the following reported case, an 82-year-old woman with a history of rapidly progressive paraparesis after a sudden middle back pain, with no previous trauma or coagulopathy, due to an acute spontaneous spinal subdural hematoma. In fact, the main difficulty was to determine, in an emergency situation, the right strategy to identify both the lesion and its cause to adapt therapeutics. This case not only provides an illustrative unusual condition in an emergency department but also a challenging discussion to choose the right treatment for a sudden neurological impairment. According to a literature review of the idiopathic cases of spinal subdural hematomas without coagulopathy, the clinical outcome depends on severity of neurological impairment. MRI is the main examination to perform in an emergency. Thus surgical evacuation should be performed in emergency in patients presenting with severe neurological impairment. SN - 1773-0619 UR - https://www.unboundmedicine.com/medline/citation/30744959/Acute_idiopathic_spinal_subdural_hematoma:_What_to_do_in_an_emergency DB - PRIME DP - Unbound Medicine ER -