[Idiopathic spinal epidural hematoma in patients with sudden paraplegia: a case report]. / Hematoma epidural espinal idiopático en pacientes con paraplejía súbita: a propósito de un caso.

ABSTRACT

INTRODUCTION: Spontaneous spinal epidural hematoma (SEH) represents 0.3-0.9% of spinal epidural space-occupying lesions, and most surgeons advocate aggressive and early surgical intervention. In this paper we describe a patient with SEH with sudden paraplegia. CASE REPORT This 30-year-old man had experienced one prior episode of sudden dorsal pain two days before the current admission and while he waited medical attendance, his legs suddenly became weak, and immediately afterwards, he became completely paraplegic in minutes. The patient had complete paraplegia, analgesia below the T4 level and urinary retention. He had no anticoagulant agent and no coagulopathic disease. He was submitted to computerized tomography that demonstrated a dorsally located epidural hematoma extending from the T3 to the T6 level with spinal cord compression. A laminectomy from T3 to T7 was performed four hours after the onset of the symptom. In postoperative time the patient presented the partial sensorial recovery and motor force grade II. The patient was directed to a neurorehabilitation program and in the last medical evaluation he presented recovery for motor grade III-IV, without pain. CONCLUSION: The SHE is rare, with severe neurological consequences for patients and early surgical treatment persist as essential for motor recovery.