Magnetic resonance imaging-monitored conservative management of traumatic spinal epidural hematomas. Report of four cases

J Neurosurg. 1999 Jul;91(1 Suppl):128-32. doi: 10.3171/spi.1999.91.1.0128.

Abstract

Spinal epidural hematomas (SEHs) are uncommon complications of traumatic injury to the spine. Emergency surgical evacuation is the standard treatment. Although it is recognized in the literature, the possibility of nonsurgical treatment of traumatic SEH is far from being codified. The authors report excellent outcomes in four conservatively managed patients who had sustained a severe spine injury with fracture of the lumbar vertebral body and in whom traumatic SEHs were diagnosed by magnetic resonance imaging. Although in the authors' experience a good spontaneous outcome in this subgroup of minimally symptomatic patients harboring moderate-sized SEHs has been achieved, further studies are necessary to understand the real spectrum of nonsurgical treatment of such lesions.

MeSH terms

  • Adult
  • Bed Rest
  • Follow-Up Studies
  • Hematoma, Epidural, Cranial / etiology
  • Hematoma, Epidural, Cranial / therapy*
  • Humans
  • Lumbar Vertebrae / injuries*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neurologic Examination
  • Retrospective Studies
  • Spinal Fractures / complications*
  • Steroids / therapeutic use
  • Treatment Outcome

Substances

  • Steroids