We report the conservative treatment of a spontaneous spinal epidural haematoma attending with acute extensive neurological deficits, which resolved spontaneously. Spontaneous remission of spontaneous spinal epidural haematoma with severe neurological deficit is rare in the literature. An 80 year old man was admitted to our hospital presenting sciatica followed by rapid development of paraparesis and cauda equina syndrome, which represents a neurosurgical emergency. Magnetic resonance imaging revealed a multilevel epidural haematoma from L1 to L5. During the initial diagnostic procedure the symptoms started to decline unexpectedly, so the surgical intervention could be withdrawn. Twenty four hours after admission the patient was almost free of symptoms, mobile, and continent. Awareness and high index of suspicion, and a willingness to seek the prompt help of the imaging department, are crucial to successful management before the opportunity to treat is lost.
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http://dx.doi.org/10.1136/emj.2003.014027 | DOI Listing |
J Cerebrovasc Endovasc Neurosurg
January 2025
Department of Neurosurgery, National Institute of Mental Health and Neuroscience (NIMHANS), Bengaluru, India.
Traumatic aneurysms represent less than 1 percent of intracranial aneurysms and middle meningeal artery pseudoaneurysms are even rare. Traumatic aneurysms are usually pseudoaneurysms formed by the rupture of all the layers of the vessel wall. They are associated with high mortality as they can present as epidural, subdural, and rarely intraparenchymal hematoma.
View Article and Find Full Text PDFCureus
December 2024
Neurosciences, Nassau University Medical Center, East Meadow, USA.
Asynchronous bilateral hematomas are exceedingly rare and pose increased risk and challenge during surgical treatment. In this case report, a 31-year-old male patient was initially found to have only a large left-sided epidural hematoma which was subsequently evacuated. An immediate postoperative CT scan demonstrated a new right-sided epidural hematoma.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Department of Orthopedics and Traumatology, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia; Department Orthopedics and Traumatology, Dr. Soetomo General Academic Hospital, East Java, Surabaya, Indonesia. Electronic address:
Introduction And Importance: Multifocal fractures in a single upper extremity represent a significant clinical challenge, often resulting from high-energy impacts such as motor vehicle accidents or severe falls. These injuries require complex, multifaceted approaches in management, spanning initial acute care to long-term rehabilitation. This paper examines the complexities of diagnosing, treating, and rehabilitating multifocal upper extremity fractures, highlighting the importance of timely intervention and a multidisciplinary approach to maximize functional recovery, minimize long-term disability and the prognosis.
View Article and Find Full Text PDFOrthop Surg
January 2025
Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China.
Background: Postoperative spinal epidural hematoma (SEH) is a rare but serious complication following lumbar surgery, with cauda equina syndrome (CES) being one of its most devastating outcomes. While CES typically presents with a combination of bladder and/or bowel dysfunction, diminished sensation in the saddle area, and motor or sensory changes in the lower limbs, atypical cases with isolated urinary symptoms are less recognized and pose significant diagnostic challenges.
Case Presentation: We report the case of a 46-year-old male who developed CES following lumbar microdiscectomy, presenting solely with urinary retention, without the classic signs of lower limb weakness or perineal sensory loss.
Neurospine
December 2024
Department of Orthopedic Surgery, Spine Center, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Objective: To compare the safety profiles of biportal endoscopic spinal surgery (BESS) and microscopic spinal surgery (MSS) for lumbar disc herniation and spinal stenosis by analyzing the associated adverse events.
Methods: We pooled data from 2 prospective randomized controlled trials involving 220 patients (110 in each group) who underwent single-level lumbar surgery. Participants aged 20-80 years with radiating pain due to lumbar disc herniation or spinal stenosis were included in this study.
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