Spinal Epidural Hematoma

Aka: Spinal Epidural Hematoma, Traumatic Spinal Epidural Hematoma

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II. Pathophysiology

  1. Expanding Spinal Epidural Hematoma results in Acute Spinal Cord Compression
  2. Uncommon disorder with potentially devastating results
    1. Often occurs without preceding Trauma

III. Risk Factors

  1. Spinal Injury
  2. Bleeding Disorder
  3. Anticoagulation

IV. Signs

  1. See Acute Spinal Cord Compression

V. Imaging

  1. See Acute Spinal Cord Compression
  2. MRI Spine
    1. T1 imaging with isointense clot appearance
    2. T2 imaging with enhancing clot appearance

VI. Management

  1. See Acute Spinal Cord Compression
  2. Emergent neurosurgery Consultation for surgical evacuation of Hematoma
  3. Reversal of Bleeding Diathesis
    1. Reverse Anticoagulation
    2. Consider Platelet Transfusion for severe Thrombocytopenia

VII. References

  1. Dasburg (2020) Crit Dec Emerg Med 34(6): 28-9

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