Spontaneous Spinal Epidural Hematoma

ABSTRACT

The spontaneous spinal epidural hematoma is rare, but the severe and permanent motor disability underlines its importance. The clinical picture begins with a local spinal and radicular pain but some hours or days later progressive neurologic symptoms develop. The standard treatment for spinal epidural hematoma has been a prompt surgical evacuation. We reported two cases of spontaneous spinal epidural hematoma which had no underlining conditions. The neurological deficit progressed to complete paraplegia despite of an early operation in one case of hematoma located in T2, 3 level, whereas another case in T10 to L2 level showed complete paraplegia at the initial evaluation but good functional recovery after the operation. The outcomes seemed to be dependent mainly on the location of hematoma in the spinal cord. So early diagnosis and prompt surgical treatment are critical to the patient with hematoma located in the upper thoracic level and progressive neurological deficit.