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REVIEW ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 2  |  Page : 44-47

Conservative management in cervical spinal epidural hematoma – A new treatment paradigm: Critical review


1 Associate Professor, Department of Neurosurgery, Government Medical College Kottayam, Kerala, India
2 Professor and Head, Department of Neurosurgery, Government Medical College Kottayam, Kerala, India

Correspondence Address:
Vinu V Gopal
Associate Professor, Department of Neurosurgery, Government Medical College Kottayam, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10039-1085

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Spinal epidural hematomas are rare, and their posttraumatic etiology is still rare. Patients' symptomatology varies from clinically silent to dense neurological deficits. Pathogenesis of progression is unclear. They usually involve multiple spinal segments. Review of the literature showed that early surgical intervention is associated with excellent outcome in patients with significant deficits. Such cases usually require long segment surgical decompression. We present a rare case review of posttraumatic long segment anterior cervical epidural hematoma with significant neurological deficit, which was managed conservatively because the patient was not willing to have any surgical intervention. The patient improved gradually with better functional outcome. Our case shows that conservative treatment may be considered as an alternate management option in the treatment of anterior spinal epidural hematomas, thus avoiding long segment decompressive laminectomy. The mechanism of spontaneous resolution of spinal epidural hematoma is also discussed with a review of the literature.


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