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Spontaneous spinal epidural haematoma: a therapeutical challenge?
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  1. J Schröder,
  2. S Palkovic,
  3. H Wassmann
  1. Department of Neurosurgery, University of Münster, D-48129 Münster, Germany
  1. Correspondence to:
 J Schröder
 Department of Neurosurgery, University of Münster, D-48129 Münster, Germany; j.schroderweb.de

Report of an unusual case

Abstract

We report the conservative treatment of a spontaneous spinal epidural haematoma attending with acute extensive neurological deficits, which resolved spontaneously. Spontaneous remission of spontaneous spinal epidural haematoma with severe neurological deficit is rare in the literature. An 80 year old man was admitted to our hospital presenting sciatica followed by rapid development of paraparesis and cauda equina syndrome, which represents a neurosurgical emergency. Magnetic resonance imaging revealed a multilevel epidural haematoma from L1 to L5. During the initial diagnostic procedure the symptoms started to decline unexpectedly, so the surgical intervention could be withdrawn. Twenty four hours after admission the patient was almost free of symptoms, mobile, and continent. Awareness and high index of suspicion, and a willingness to seek the prompt help of the imaging department, are crucial to successful management before the opportunity to treat is lost.

  • MRI, magnetic resonance imaging
  • SEH, spinal epidural haematoma
  • SSEH, spontaneous spinal epidural haematoma
  • spontaneous spinal epidural haematoma
  • hematoma
  • nonoperative treatment
  • cauda equina syndrome
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Footnotes

  • Funding: none

  • Competing interests: none declared

  • Patient consent was obtained

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