Microsurgical Treatment of Spontaneous and non-Spontaneous Spinal Epidural Haematomas: Neurological Outcome in Relation to Aetiology |
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Authors: | V Rohde W Küker M H T Reinges J M Gilsbach |
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Institution: | (1) Department of Neurosurgery, Technical University (RWTH) Aachen, Germany, DE;(2) Department of Neuroradiology, Technical University (RWTH) Aachen, Germany, DE |
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Abstract: | Summary Background. This retrospective study evaluated the neurological outcome of 26 patients with spontaneous and non-spontaneous spinal epidural
haematoma (SEH) who underwent microsurgical clot removal. It was the objective of the present study to investigate whether
the aetiology of the SEH has an influence on the neurological outcome.
Methods. The medical records and radiological investigations of 26 patients with SEH were re-examined, and the latency between symptom
onset and operation, and the size of the haematoma were determined. Motor and sensory function had been evaluated before surgery
and 90 days after discharge.
Findings. Fourteen patients with non-spontaneous SEH and 12 patients with spontaneous SEH were identified. After surgery, neurological
deficits improved in 9 of the patients with spontaneous (75%) and in 13 of the patients with non-spontaneous SEH (93%). In
cases of spontaneous SEH, the median latency between symptom onset and operation was longer (72 hrs vs 7 hrs) and the median
extent of the haematoma was larger (3.5 vs 2 spinal segments), than in the non-spontaneous cases.
Interpretation. Neurological outcome seems to be related to the aetiology of the SEH. Better outcome was observed in patients with surgically
treated non-spontaneous SEH. Two explanations for this finding are worth considering. First, patients with non-spontaneous
SEH usually are already under medical surveillance and can undergo medullary decompression more rapidly. Second, the compression
of the spinal cord is possibly less severe in non-spontaneous SEH because of their smaller size. |
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Keywords: | : Neurological outcome spontaneous spinal epidural haematoma non-spontaneous spinal epidural haematoma surgical timing spinal cord compression |
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