Traumatic Spinal Epidural Hematoma with Neurological Deficit

Sema Avcı* and Muhammet Taha Eser

Traumatic Spinal Epidural Hematoma with Neurological Deficit

The incidence of SEH is roughly 0.1 per 100.000 per year. SEH
rate of incidence is 4:1 between men and women. In literatüre,
accessing to information about post-traumatic SEH is uncommon so that
pathophysiology of SEH is unclear and risk factors
can change according to every patient with SEH.

Spinal epidural hematomas could be present paralysis of the lower extremity,
cauda equina syndrome, local or radicular back pain in regard to
location of spinal blood collection but sometimes asymptomatic cases could be seen. Prevalently,
blood collection in the spinal cord originates at the posterior surface by
reason of anatomical location of venous plexus.

Blood collection can be determined
anywhere in spinal canal between dura and spine but also SEHs
are more common than the cervical. Early diagnosis of spinal
epidural hematoma is difficult because of its unusual occurence
whereas normal neurological examination may cause retardation of diagnosis.2

The physician should think about epiduritis,
neuralcyst, slipped disc and tumor in the differential diagnosis
of spinal epidural hematoma. MRI is used for diagnosis of SEH
and surgical intervention which should be treated immediately
but some authors argue for any surgical intervention if the patient
has minimal neurologic deficit.

Epidural hematoma can be seen hypointense, isointense or hyperintense signal in T1-weighted
images due to hemorrhage age.

If the decompression of SEH within 12 hours, the outcome will
be better. Wahjoepramon reported a case of traumatic subacute traumatic
spinal epidural hematoma in a 4-year-old boy with
distinct neurological deficits and completely recovered.

Emerg Med Open J. 2017; 3(2): 42-43. doi: 10.17140/EMOJ-3-139