Spontaneous Spinal Epidural Hematoma: A Concise Review

Abstract

Spontaneous spinal epidural hematoma (SSEH) is an entity of rarity. It usually has an acute onset presenting to the emergency department with profound neurological deficits.From the term we infer that the blood accumulating in the spinal column is not due to any traumatic cause.During the episode of spontaneous bleeding, there is a positive correlation with increase in the pressures of the epidural space. Replacing myelography and CT scan, MRI has earned the name for being the gold standard for the diagnosis of SSEH. In case of an individual without any classical explanation for developing sudden neurological deficits with excruciating painful symptoms, SSEH should be kept in mind as a potential differential diagnosis. If SSEH is suspected, MRI should be done which is the diagnostic modality of choice.Surgical evacuation of the hematoma and decompression with laminectomy are considered to be the ideal procedures to be performed following the diagnosis.Since SSEH is a dreaded problem causing rapid deterioration it is highly advised to take up the patient for a detailed diagnosis and timely interventional procedures even though the clinical symptomatology remains to be highly unique in different individuals. In this article, we discuss from the literature, the etiology, pathophysiology, diagnosis, treatment protocols and prognostic factors regarding SSEH, a disease of low incidence yet a high mortality, demanding a detailed discussion and awareness among the medical professionals.