Conservative Treatment of Acute Spontaneous Spinal Epidural Hematoma

Peter A. Pahapill and Stephen P. Lownie

Abstract: Background: In cases of acute spontaneous spinal epidural hematoma producing neurological deficits, emergency surgical evacuation is the standard treatment. Methods: Such a case is presented in which complete resolution of neurological deficits occurred without surgical intervention. Results: This is the fifth reported case of complete recovery in a patient managed conservatively. In most reports, significant and sustained neurological recovery had occurred within 12 hours of impairment of walking. Conclusion: In cases of acute spontaneous spinal epidural hematoma in which neurological deterioration is followed by early and sustained recovery, non-operative therapy may be considered.

Can. J. Neurol. Sci. 1998; 25: 159-163