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Spinal subdural and epidural hematoma
Last reviewed: 23.04.2024
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Spinal subdural or epidural hematoma is the accumulation of blood in the subdural or epidural space, which can cause compression of the spinal cord.
Spinal subdural or epidural hematoma (usually in the thoracic or lumbar region) is rare, but can develop after back injuries, anticoagulant or thrombolytic therapy, or in patients with hemorrhagic diathesis after lumbar puncture. Symptoms start with local or radicular pain and soreness with percussion, usually they are very pronounced. The compression of the spinal cord may develop, compression in the lumbar spine can cause compression of the roots of the horse's tail and paresis of the lower limbs. The neurologic deficit progresses from minutes to hours.
Spinal subdural or epidural hematoma may be suspected in patients with acute nontraumatic compression of the spinal cord or acute unexplained paresis of the lower limbs, especially in the presence of possible causes (eg trauma, hemorrhagic diathesis). Diagnosis - MRI, but if MRI is not possible, myelography plus CT is performed. Treatment - urgent surgical drainage. Patients receiving coumarins (warfarin) should receive vitamin K 2.5-10 mg subcutaneously and freshly frozen plasma if necessary before normalizing MHO. Patients with thrombocytopenia are shown to have a platelet transfusion.
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