[Spontaneous spinal epidural hematoma]. / Hematoma epidural espinal espontáneo.

Spontaneous spinal epidural hematoma Spinal epidural hematoma is defined as spontaneous when there is no known underlying cause or predisposing bleeding factor. Its incidence is very low, approximately one per million inhabitants per year. However, it may cause acute and irreversible neurological symptoms. For this reason, it is considered a neurosurgical emergency that requires rapid diagnosis and treatment. The most common clinical presentation involves acute vertebral pain with radicular radiation to one or several limbs) followed by neurological signs below the lesion. Neuroradiology imaging, particularly the magnetic resonance imaging, will determine the topography and diagnosis. There are some case reports in the literature that resolved spontaneously, however, most patients require laminectomy and drainage of the hematoma. We report the case of a 65 year-old woman with a background of hypertension, who presented with an acute pain syndrome in the interscapular region radiating to both upper limbs, followed by right sided hemiparesis, as the initial symptom and sign of a spontaneous spinal epidural hematoma.

Hematoma epidural espinal espontáneo / Spontaneous spinal epidural hematoma

El hematoma epidural espinal se define como espontáneo cuando se produce sin que exista una causa subyacente o un factor predisponente para el sangrado. Es una entidad con baja incidencia (aproximadamente uno por millón de habitantes y año), pero que puede causar un déficit neurológico rápido e irreversible. Por tanto, se considera una urgencia neuroquirúrgica que requiere un diagnóstico y tratamiento precoces. La presentación clínica más habitual suele consistir en un dolor brusco a nivel espinal con irradiación radicular (a uno o varios miembros) seguido de un déficit neurológico por debajo de la lesión. Las pruebas neurorradiológicas y sobre todo la resonancia magnética nos van a permitir hacer un diagnóstico definitivo. Aunque existen descritos en la literatura algunos casos en los que ha habido resolución espontánea, la mayoría de ellos va a precisar tratamiento quirúrgico con laminectomía y evacuación del hematoma. Presentamos el caso clínico de una mujer de 65 años con antecedentes de hipertensión arterial que acude a urgencias por dolor de inicio brusco en región interescapular irradiado a ambos brazos, seguido de paresia braquiocrural derecha, aguda, como manifestación inicial de un hematoma epidural espinal espontáneo

Spontaneous spinal epidural hematoma Spinal epidural hematoma is defined as spontaneous when there is no known underlying cause or predisposing bleeding factor. Its incidence is very low, approximately one per million inhabitants per year. However, it may cause acute and irreversible neurological symptoms. For this reason, it is considered a neurosurgical emergency that requires rapid diagnosis and treatment. The most common clinical presentation involves acute vertebral pain with radicular radiation to one or several limbs) followed by neurological signs below the lesion. Neuroradiology imaging, particularly the magnetic resonance imaging, will determine the topography and diagnosis. There are some case reports in the literature that resolved spontaneously, however, most patients require laminectomy and drainage of the hematoma. We report the case of a 65 year-old woman with a background of hypertension, who presented with an acute pain syndrome in the interscapular region radiating to both upper limbs, followed by right sided hemiparesis, as the initial symptom and sign of a spontaneous spinal epidural hematoma