Spinal epidural hematoma
| Spinal epidural hematoma | |
|---|---|
| Specialty | Neurology |
Spinal extradural haematoma or spinal epidural hematoma (SEH) is bleeding into the epidural space in the spine. These may arise spontaneously (e.g. during childbirth), or as a rare complication of epidural anaesthesia or of surgery (such as laminectomy).[citation needed] Symptoms usually include back pain which radiates to the arms or the legs.[1] They may cause pressure on the spinal cord or cauda equina, which may present as pain, muscle weakness, or dysfunction of the bladder and bowel.
Pathophysiology
[edit]The anatomy of the epidural space is such that spinal epidural hematoma has a different presentation from intracranial epidural hematoma. In the spine, the epidural space contains loose fatty tissue and a network of large, thin-walled veins, referred to as the epidural venous plexus. The source of bleeding in spinal epidural hematoma is likely to be this venous plexus.[citation needed]
Diagnosis
[edit]The best way to confirm the diagnosis is MRI.[1] Risk factors include anatomical abnormalities and bleeding disorders.
Treatment
[edit]Treatment is generally with emergency surgery.[1] The risk following epidural anaesthesia is difficult to quantify; estimates vary from 1 per 10,000 to 1 per 100,000 epidural anaesthetics.[citation needed]