Clinical feature and surgical treatment of spontaneous spinal epidural hematoma

We presented 10 patients of spontaneous spinal epidural hematoma (SSEH) who were surgically treated between July 1996 and June 2003. One male and 9 female patients whose ages ranged from 16 to 75 years (mean age is 60) enrolled in this study. All cases initially presented with severe back and radicular pain followed by sensory and motor dysfunction. Sphincter dysfunction was observed in 8 patients. Although three cases were initially suspected as cardiovascular diseases and two as cerebral stroke, all cases were successfully diagnosed with magnetic resonance imaging studies. The hematoma was located at the dorsal cervical levels in 3 cases, the dorsal cervicothoracic in 1, the dorsal thoracic in 4, the ventral thoracic in 1, and the ventral lumbosacral in 1. After surgical evacuation of the hematoma, neurological dysfunctions improved in all patients. In particular, surgical decompression was performed within 36 hours after onset in 5 cases suffering severe neurological dysfunction according to the Frankel Grading System. To obtain good prognosis for patients with SSEH, early diagnosis and immediate treatment are important.