[Spontaneous spinal hematoma]

The spontaneous spinal hematoma is a rare and serious pathology. Through four observations colliged in the service of neurosurgery of the CHU of Casablanca, over one 10 years period, the authors point out the topographic, etiology aspects and the principles of treatment. Four types are distinguished according to the localization compared to the dura mater; the epidural hematoma, sub-dural hematoma, the sub-arachoidienne haemorrhage, and intra-medullarly hematoma. The etiologies are dominated by three principal causes with knowing; disorders of coagulation, arteriovenous malformations and the haemorrhage of tumoral origin. The assumption of responsibility starts with the correction of possible disorders of the coagulation generally followed by surgical evacuation

Non-traumatic spinal cord compression in children: 45 cases

Spinal cord compression occurs rarely in childhood and the diagnosis is usually made too late. We report 45 cases of non-traumatic spinal cord compression collected in our department between January 1982 and December 2002. Mean age was 11 years old with a male sex predominance [sex-ratio: 1.6]. Average delay of admission was 5 months. The most frequent complaints were gait disturbance [84.4%], pain [radicular or spinal] [66%] and sphincter dysfunction [24.4%]. Plain radiographs showed abnormalities in 46%. Magnetic resonance imaging has been more indicated since 1994. The distribution of lesions can be summerised as follows: predominance of dorsal involvement [37.7%], extramedullary lesions [75.6%] tumoural aetiologies [71.5%]. Forty-three cases were operated; 40 cases via posterior approach with laminectomy [33 cases] and laminotomy [7 cases], while anterior approach was performed in only 3 cases. Postoperative course showed neurologic improvement in 11 cases [24.4%], a stationary state in 28 cases [62.2%], and 3 cases of death. Unfortunately the long term outcome could not be followed in the majority of cases