Epidural Hematoma Definition
An epidural hematoma is most accurately defined as blood accumulation in the potential space between the bone and dura. It is also referred as epidural hemorrhage and epidural bleed.
Epidural hematoma can either be spinal (SEDH) or intracranial (EDH).
The epidural space, an outermost portion of the spinal canal, is the location where an epidural needle is inserted when performing epidural analgesia (epidural injection to numb lower half of the body).
In this post, we will be focusing more on Spinal Epidural Hematoma or SEDH.
Spinal Epidural Hematoma
1) Spinal Epidural Hematoma’s (SEDH) can be spontaneous or caused by trauma.
Spinal epidural hematomas are usually caused by a form of trauma to the neck or spine, but can also happen spontaneously (although rare).
There has been some debate as to whether high blood pressure is a causative factor for spontaneous spinal epidural hematoma (SSEH), but it has not been accepted as a sole reason for its occurrence.
2) Spinal Epidural Hematoma symptoms.
Spinal epidural hematoma usually results to severe localized back pain accompanied with delayed radicular radiation. It may mimic disk herniation.
Other significant symptoms may include numbness, fecal incontinence, weakness, and urinary incontinence.
3) SSEH starts with a sudden pain in the neck or back.
It is due to the level of lesion. A sudden collection of blood in the space between the spinal epidural and the bone can impair normal functioning of the affected parts.
The progression from pain to paraparesis can be anywhere from minutes to hours.
4) How it is diagnosed.
SEDH can be diagnosed with a simple MRI.
If a patient is suspected of having a hematoma, an MRI will indicate whether or not it is present along with the location.
An MRI is a painless procedure that involves the body being scanned by an MRI machine that takes pictures of the internal parts of the patient’s body.
5) SEDH happens more often at certain ages.
The age group that most unlikely develop SEDH are those in childhood where it is most common in the fifth and sixth decade of life.
Increased age has been recognized as a risk in postoperative spinal epidural hematoma, though an SEDH can occur at any time of life.
6) SEDH is a neurological condition.
Despite SEDH being located in the neck or back, it is considerably a neurological condition due to the impact that brings on the nerves of the spinal cord.
As SSEH can result in paraparesis or quadriparesis, the condition is treated by a neurologist.
7) The treatment is acted on very soon after diagnosis.
Though the symptoms of SEDH are somewhat alarming, it is fairly possible to treat the condition.
Most patients are placed on immediate surgical drainage to empty the hematoma.
A partial hemilaminectomy may also be necessary to remove the hematoma.
Both procedures help restore any disturbed neurological effects back to normal.
After being diagnosed with SEDH, surgical remedy is done within 48 hours. This is to prevent further damage to the spine and to alleviate the symptoms as quickly as possible.
8) There’s been a debate as to where the hematomas come from.
Though the hematomas are easy to locate and effective treatment exists, there have still been debates as to where they actually come from.
However, it’s likely that hematomas are caused by arterial bleeding compressing the spinal cord, it has not been unanimously agreed upon.
9) Spontaneous Spinal Epidural Hematoma (SSEH) is relatively rare.
The good news is that SSEH is relatively rare.
Only 0.1 of 100,000 of people will ever experience SSEH, and only 1% of them will develop lesions in the hematoma area.
10) Seek medical attention.
If you are experiencing pain in your neck or back, along with numbness in areas of your body, go to the hospital immediately!
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