Nonaccidental head injury, as seen in domestic child abuse cases, is often associated with spinal injury, and spinal subdural hematoma is the most frequent diagnosis. While spinal epidural hematomas are a rare occurrence, the incidence of spontaneous epidural hematomas occurring in nonaccidental head injury patients is even lower. Epidural hematomas often result in acute focal neurological deficits necessitating emergent neurosurgical intervention. In patients without focal neurological deficits, conservative management may allow for spontaneous resolution of the epidural hematoma. The authors present the case of a 2-year-old boy with a large spinal epidural hematoma resulting after an event of nonaccidental injury, specifically, domestic child abuse. This patient exhibited no focal neurological deficits and was managed conservatively without surgical clot evacuation. On a follow-up visit, repeat imaging studies demonstrated a stable resolution of spinal epidural hematoma, providing further support for the safety of conservative management in these patients.
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http://dx.doi.org/10.1159/000448737 | DOI Listing |
Cureus
December 2024
Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, EGY.
Adhering to established guidelines, regional anesthesia (RA) and pain interventions are essential for preventing or minimizing the risk of complications. This study examines neurological complications that may arise when RA or pain interventions are performed without adherence to the clinical practice guidelines. This article aimed to emphasize the relationship between deviations from standards of care in RA and neurological outcomes.
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Neurosurg Rev
January 2025
Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
This study aims to thoroughly investigate the clinical presentation, duration of symptoms, radiological aspects of posterior epidural migration of disc fragments (PEMDF), and assess various treatment options and their impacts on patient functionality. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a comprehensive search in PubMed, Web of Science, and Scopus from inception to March 2024.
View Article and Find Full Text PDFSpine J
January 2025
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:
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View Article and Find Full Text PDFJ Emerg Med
August 2024
Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina; Durham Veterans Affairs Healthcare System, 508 Fulton St, Durham, North Carolina. Electronic address:
Background: Rib fractures are frequently diagnosed and treated in the emergency department (ED). Thoracic trauma has serious morbidity and mortality, particularly in older adults, with complications including pulmonary contusions, hemorrhage, pneumonia, or death. Bedside ED-performed ultrasound-guided anesthesia is gaining in popularity, and early and adequate pain control has shown improved patient outcomes with rare complications.
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