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• Vol.54 No.5
• CLINICA NEUROL, 54: 395−402, 2014
• Vol.54 No.5 contents

Original Article

Clinical manifestations of 16 patients with spontaneous spinal epidural hematoma
-Stroke mimic and pitfalls for diagnosis-

Naoyuki Hara, M.D.¹⁾³⁾, Tatsuya Otonari, M.D., Ph.D.²⁾, Nobuharu Nishihara, M.D.²⁾, Taisei Ota, M.D.²⁾ and Masaru Kuriyama, M.D., Ph.D.¹⁾

¹⁾Department of Neurology, Brain Attack Center, Ota Memorial Hospital
²⁾Department of Spinal Surgery, Brain Attack Center, Ota Memorial Hospital
³⁾Present Address: Department of Neurology, Hiroshima City Hospital

Clinical manifestations of 16 patients with spontaneous spinal epidural hematoma were presented. We examined the point similar to that of stroke. During the initial visit of our hospital, the patients showed the hemiplegia in 10 cases (62.5%), Horner syndrome in 4 cases (25%), the painless onset in 1 case (6.3%). And one case showed the impairment of consciousness due to vagal reflex in severe pain onset, which was similar to those of subarachnoid hemorrhage. MRI images are useful to confirm the diagnosis. The frequent site of hematoma was the lower cervical spinal cord. The oval shaped hematomas shifted to the left or right in spinal canals, compressed spinal cords in axial image, which was a cause of hemiplegia. Many cases developed during active periods, and the hemorrhage might be relevant to oral antithrombotic agent, C hepatitis, and chronic renal failure. Rapidly progressive cases were indications for emergency surgery, but conservative therapy is also possible and was better prognosis.
Full Text of this Article in Japanese PDF (4124K)

(CLINICA NEUROL, 54: 395−402, 2014)
key words: spontaneous spinal epidural hematoma, stroke mimic, hemiplegia, Horner syndrome, MRI

(Received: 13-Aug-13)