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Spontaneous spinal epidural hematomas: One case report and rehabilitation outcome

RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but potentially disabling disease, and the classical presentation of it includes an acute onset of severe, sometimes radiating back or neck pain, followed by signs and symptoms of rapidly evolving nerve root or spinal cord c...

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Autores principales: Xian, Hang, Xu, Li-Wei, Li, Cong-Han, Hao, Jian-Ming, Wan, Wei-Xia, Feng, Guo-Dong, Lian, Ke-Jian, Li, Lin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682821/
https://www.ncbi.nlm.nih.gov/pubmed/29095302
http://dx.doi.org/10.1097/MD.0000000000008473
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author Xian, Hang
Xu, Li-Wei
Li, Cong-Han
Hao, Jian-Ming
Wan, Wei-Xia
Feng, Guo-Dong
Lian, Ke-Jian
Li, Lin
author_facet Xian, Hang
Xu, Li-Wei
Li, Cong-Han
Hao, Jian-Ming
Wan, Wei-Xia
Feng, Guo-Dong
Lian, Ke-Jian
Li, Lin
author_sort Xian, Hang
collection PubMed
description RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but potentially disabling disease, and the classical presentation of it includes an acute onset of severe, sometimes radiating back or neck pain, followed by signs and symptoms of rapidly evolving nerve root or spinal cord compression. PATIENT CONCERNS: Here, we report a 26-year-old female patient presented with weakness in bilateral lower extremities, progressing to intense paraplegia and anesthesia without recent medical history of trauma, infection, surgery, or drug use. DIAGNOSIS: A magnetic resonance imaging (MRI) scan of spinal cord was planned and a posterior epidural hematoma of the thoracic spine was observed. INTERVENTIONS: A posterior decompression and hematoma evacuation was performed after diagnosis immediately. Early rehabilitation program of the specific kind spinal cord injury was formulated and implemented. OUTCOMES: The patient finally can handle basic living activities, such as completing wheelchair locomotion, transferring from bed to wheelchair independently after 3 months of rehabilitation. LESSONS: SSEH is a rarely occurring case in emergency. Acute chest pain and paraplegia could be the initial presentation of acute spinal epidural hemorrhage, but the diagnosis of patient without classical manifestations is still a challenge for doctors. Early diagnosis, prompt decompression, and individualized rehabilitation program can improve the prognosis and outcome.
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spelling pubmed-56828212017-11-28 Spontaneous spinal epidural hematomas: One case report and rehabilitation outcome Xian, Hang Xu, Li-Wei Li, Cong-Han Hao, Jian-Ming Wan, Wei-Xia Feng, Guo-Dong Lian, Ke-Jian Li, Lin Medicine (Baltimore) 6300 RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but potentially disabling disease, and the classical presentation of it includes an acute onset of severe, sometimes radiating back or neck pain, followed by signs and symptoms of rapidly evolving nerve root or spinal cord compression. PATIENT CONCERNS: Here, we report a 26-year-old female patient presented with weakness in bilateral lower extremities, progressing to intense paraplegia and anesthesia without recent medical history of trauma, infection, surgery, or drug use. DIAGNOSIS: A magnetic resonance imaging (MRI) scan of spinal cord was planned and a posterior epidural hematoma of the thoracic spine was observed. INTERVENTIONS: A posterior decompression and hematoma evacuation was performed after diagnosis immediately. Early rehabilitation program of the specific kind spinal cord injury was formulated and implemented. OUTCOMES: The patient finally can handle basic living activities, such as completing wheelchair locomotion, transferring from bed to wheelchair independently after 3 months of rehabilitation. LESSONS: SSEH is a rarely occurring case in emergency. Acute chest pain and paraplegia could be the initial presentation of acute spinal epidural hemorrhage, but the diagnosis of patient without classical manifestations is still a challenge for doctors. Early diagnosis, prompt decompression, and individualized rehabilitation program can improve the prognosis and outcome. Wolters Kluwer Health 2017-11-03 /pmc/articles/PMC5682821/ /pubmed/29095302 http://dx.doi.org/10.1097/MD.0000000000008473 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 6300
Xian, Hang
Xu, Li-Wei
Li, Cong-Han
Hao, Jian-Ming
Wan, Wei-Xia
Feng, Guo-Dong
Lian, Ke-Jian
Li, Lin
Spontaneous spinal epidural hematomas: One case report and rehabilitation outcome
title Spontaneous spinal epidural hematomas: One case report and rehabilitation outcome
title_full Spontaneous spinal epidural hematomas: One case report and rehabilitation outcome
title_fullStr Spontaneous spinal epidural hematomas: One case report and rehabilitation outcome
title_full_unstemmed Spontaneous spinal epidural hematomas: One case report and rehabilitation outcome
title_short Spontaneous spinal epidural hematomas: One case report and rehabilitation outcome
title_sort spontaneous spinal epidural hematomas: one case report and rehabilitation outcome
topic 6300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682821/
https://www.ncbi.nlm.nih.gov/pubmed/29095302
http://dx.doi.org/10.1097/MD.0000000000008473
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