Spinal epidural hematoma is a space-occupying lesion caused by several cause. It has been reported after trauma, lumbar puncture, epidural anesthesia, operation, coagulopathy, vascular malformation, neoplasm, hypertension, diabetes mellitus, pregnancy, anticoagulative medication, etc4,7,9,10,17,19,24).
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.
Can you recover from epidural hematoma?
In adults, most recovery occurs in the first 6 months. Usually there is some improvement over 2 years. If there is brain damage, full recovery isn’t likely.
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.
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.
How is an epidural hematoma treated?
In most cases, your doctor will recommend surgery to remove an epidural hematoma. It usually involves a craniotomy. In this procedure, your surgeon will open up part of your skull so they can remove the hematoma and reduce the pressure on your brain. In other cases, your doctor may recommend aspiration.
How is a spinal epidural hematoma treated?
Treatment. Treatment of a spinal subdural or epidural hematoma is immediate surgical drainage. Patients taking coumarin anticoagulants are given phytonadione (vitamin K1) 2.5 to 10 mg subcutaneously and fresh frozen plasma as needed to normalize the INR (international normalized ratio).
Can you see a hematoma on an MRI?
MRI is the most sensitive imaging test available for the detection of subdural hematomas. Small subdural hematomas are occasionally difficult to distinguish from epidural hemorrhages.
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 you get rid of a blood clot in your spine?
To treat a blood clot, you may be prescribed medications known as antiplatelet and anticoagulant drugs, such as aspirin and warfarin (Coumadin). These drugs reduce the chance of another clot forming. For high blood pressure, you may be prescribed a medication that lowers your blood pressure.
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.