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Resolution of Spontaneous Spinal Epidural Hematoma Without Surgery: Report of Two Cases

Hentschel, Stephen J. MD*‡; Woolfenden, Andrew R. MD†‡; Fairholm, David J. MD*‡

Case Reports

Study Design.  Case report.

Objective.  To report two cases of spontaneous spinal epidural hematoma that completely resolved, clinically and radiographically, without surgical treatment.

Summary of Background Data.  The treatment of spinal epidural hematoma is usually surgical. Spontaneous spinal epidural hematoma is an uncommon phenomenon and may be of uncertain cause.

Methods.  One patient with acute onset of complete quadriplegia and another with complete paraplegia caused by spontaneous spinal epidural hematoma were treated without surgery.

Results.  Both patients recovered nearly completely with respect to their neurologic function at 3-month follow-up. No source of hematoma was ever identified.

Conclusions.  Spontaneous spinal epidural hematoma should be considered in the differential diagnosis of sudden onset of spinal cord compression in association with back pain. Patients initially presenting with severe neurologic dysfunction are potential candidates for conservative management if they demonstrate rapid and progressive improvement in neurologic function. Patients treated in this manner can have nearly complete restoration of function.

From the *Division of Neurosurgery, Department of Surgery, the

†Division of Neurology, Department of Medicine, University of British Columbia, and the

‡Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada.

Acknowledgement date: November 14, 2000.

First revision date: April 2, 2001.

Second revision date: May 28, 2001.

Acceptance date: June 4, 2001.

Device status category: 1.

Conflict of interest category: 12.

Address reprint requests to

Andrew Woolfenden, MD

Vancouver General Hospital

Stroke Study Office

855 West 12th Ave

Vancouver, BC, V5Z 1 M9

Canada

E-mail: vghsso@interchange.ubc.ca

© 2001 Lippincott Williams & Wilkins, Inc.