How is a spinal hematoma diagnosed?

A spinal subdural or epidural hematoma is an accumulation of blood in the subdural or epidural space that can mechanically compress the spinal cord. Diagnosis is by MRI or, if not immediately available, by CT myelography.

What does a spinal hematoma feel like?

A spinal hematoma is a collection of blood that compresses the spinal cord and nerve roots. Significant compression of the spinal cord can result in irreversible neurologic damage. Symptoms may include pain, weakness, numbness, difficulty walking, loss of bowel and/or bladder control, or paralysis.

How do you know if you have an epidural hematoma?

Headache (severe) Head injury or trauma followed by loss of consciousness, a period of alertness, then rapid deterioration back to unconsciousness. Nausea or vomiting. Weakness in part of the body, usually on the opposite side from the side with the enlarged pupil.

How do they test for epidural hematoma?

How is an epidural hematoma diagnosed?

  1. neurological tests.
  2. computed tomography (CT) scans or magnetic resonance imaging (MRI) to examine your skull and the soft tissue in your brain.
  3. electroencephalogram (EEG) to assess your brain’s electrical activity.
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How serious is a spinal hematoma?

Typically, the hematoma is asymptomatic, but in rare cases it will compress the spinal cord, with potentially devastating neurological consequences. These symptoms include sensory disruption, bowel and bladder incontinence, motor weakness, or, in severe cases, complete paralysis of the affected limbs.

How long does it take for a spinal hematoma to reabsorb?

A hematoma is not a bruise. Depending on the cause, it can take anywhere from 1 to 4 weeks for a hematoma to go away.

What are signs of a hematoma?

Pain, swelling, redness, and disfiguring bruises are common symptoms of hematoma in general. Some symptoms specific to the location of a hematoma are: Subdural hematoma symptoms: headache, neurologic problems (weakness on one side, difficulty speaking, falling), confusion, seizures.

Do all epidural hematomas need surgery?

Not all cases of acute EDH require immediate surgical evacuation. If a lesion is small and the patient is in good neurological condition, observing the patient with frequent neurological examinations is reasonable.

How common are epidural hematomas?

Epidural hematoma complicates 2% of cases of head trauma (approximately 40,000 cases per year). Spinal epidural hematoma affects 1 per 1,000,000 people annually. Alcohol and other forms of intoxication have been associated with a higher incidence of epidural hematoma. The incidence has remained stable over many years.

Where is the epidural hematoma located?

An epidural hematoma (EDH) occurs when blood accumulates between the skull and the dura mater, the thick membrane covering the brain. They typically occur when a skull fracture tears an underlying blood vessel. EDHs are about half as common as a subdural hematomas and usually occur in young adults.

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Who is at risk for epidural hematoma?

Increased age, history of GI bleeding, aspirin use during anticoagulation, length of therapy, female gender, and intensity of anticoagulant effect (ie INR 2-3 less likely to cause major bleeding than INR >4)are all known risk factors for bleeding during anticoagulation and also increase the risk of an epidural hematoma …

When does a hematoma need to be drained?

Sometimes, a hematoma may require surgical drainage. Surgery may be more likely if the blood is putting pressure on the spinal cord, brain, or other organs. In other cases, doctors may want to drain a hematoma that is at risk of infection.

Can a hematoma be permanent?

If a clot from a hematoma reenters the bloodstream, it can block an artery, cutting off blood flow to part of the body. Without prompt treatment, this can result in permanent tissue damage.

Can a spinal tap cause a hematoma?

Spinal hematomas are usually treated conservatively unless patients present with neurological compromise. One cause for spinal hematoma is lumbar puncture (LP), which often goes without close follow up unless the patient reports issues.

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