Abstract Details

Title Spontaneous Spinal Epidural Hematoma: Clinical, Radiological and Therapeutic Features in a Series of Eleven Cases

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) P03 - (-)

Poster/Presentation
Number 142

Objective

Background BACKGROUND: Spontaneous spinal epidural hematoma is an uncommon disorder (incidence rate: one case per million person-years). Its etiology is unknown although several predisposing factors have been proposed.

Design/Methods DESIGN/METHODS: A retrospective study of the patients diagnosed with SSEH between 2001-2011 in our hospital was conducted. Epidemiological, clinical, therapeutic features and prognosis were analyzed.

Results RESULTS: Total number of cases: 11. Female: 7(63%). Mean age was 70(27-88). Main risk factors were hypertension: 7(63%) and oral anticoagulation therapy: 7(63%). Most common clinical presentation was back pain: 9(81.8%), (radiating back pain: 4). Mean time from onset of symptoms to spinal cord dysfunction was 9 hours (0-48). Symptoms: motor deficit: 10 (paraparesis: 2; hemiparesis: 4; paraplegia: 3; tetraplegia: 1). Sensory deficit: 8. Location of SEEH: cervical: 5, thoracic: 1, several spine regions: 5. Treatment: decompressive surgery of cervical hematoma: 4; esteroids: 6; spontaneous remission: 1. Mean time from onset of symptoms to medical consultation: radiating back pain group: 4.4 hours, (range:1-12); surgically treated patients: 5.6 hours (range:1-12); conservatively treated patients: 52.2 hours (range:18-72). Median time from onset of symptoms to surgery: 23.5 hours. Modified Rankin scale one year after discharge: surgically treated group, 1.25 (range 0-2); conservatively treated group 2.3 (range 0-5).

Conclusions CONCLUSIONS: Hypertension and oral anticoagulation therapy are the most common risk factors associated with SSEH. Most frequent clinical presentation was back pain. Favorable outcome was related with radiating back pain at onset, early consultation, cervical hematoma localization and surgical treatment.

Authors/Disclosures
PRESENTER	No disclosure on file
Fernando Romero Delgado	No disclosure on file
	No disclosure on file
	No disclosure on file
Thomas P. Bleck, MD, FAAN (Northwestern University Department of Neurology)	Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Marinus Pharmaceuticals. Dr. Bleck has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for iECURE. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acasti. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Society of Critical Care Medicine. Dr. Bleck has received research support from NIH.
Juan Pablo Cuello (Hospital General Universitario Gregorio Maran)	Juan Pablo Cuello has nothing to disclose.
Pedro Rodriguez Cruz	No disclosure on file
	No disclosure on file
	No disclosure on file
David Ezpeleta	No disclosure on file

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