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Spine
Diagnosis
Trauma
Cord, Dura, and Vessels
Traumatic Epidural Hematoma
Traumatic Epidural Hematoma
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Spinal epidural hematoma (SEH)

              • Definitions

                • Posttraumatic accumulation of blood into spinal epidural space

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Nonvascular Interventions

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Domenicucci M et al: Spinal epidural hematomas: personal experience and literature review of more than 1000 cases. J Neurosurg Spine. 27(2):198-208, 2017
                                            2. Wolf M et al: Neuroimaging of the traumatic spine. Magn Reson Imaging Clin N Am. 24(3):541-61, 2016
                                            3. Giugale JM et al: Traumatic brachial plexus root avulsion and cervical spine epidural hematoma in an 18 year old male. Spine J. 15(2):365-6, 2015
                                            4. Pérez-Bovet J et al: Traumatic epidural retroclival hematoma with odontoid fracture and cardiorespiratory arrest. Spinal Cord. 51(12):926-8, 2013
                                            5. Rangarajan V et al: Traumatic cervical epidural hematoma in an infant. J Craniovertebr Junction Spine. 4(1):37-9, 2013
                                            6. Kiran NA et al: Two children with traumatic thoracic spinal epidural hematoma. J Clin Neurosci. 16(10):1356-8, 2009
                                            7. Groen RJ: Non-operative treatment of spontaneous spinal epidural hematomas: a review of the literature and a comparison with operative cases. Acta Neurochir (Wien). 146(2):103-10, 2004
                                            8. Kirwan R et al: Nontraumatic acute and subacute enhancing spinal epidural hematoma mimicking a tumor in a child. Pediatr Radiol, 2004
                                            9. Liao CC et al: Experience in the surgical management of spontaneous spinal epidural hematoma. J Neurosurg. 100(1 Suppl):38-45, 2004
                                            10. Chang FC et al: Contrast enhancement patterns of acute spinal epidural hematomas: a report of two cases. AJNR Am J Neuroradiol. 24(3):366-9, 2003
                                            11. Kreppel D et al: Spinal hematoma: a literature survey with meta-analysis of 613 patients. Neurosurg Rev. 26(1):1-49, 2003
                                            12. Lang SA et al: Spinal epidural hematoma and epidural analgesia. Can J Anaesth. 50(4):422-3, 2003
                                            13. Muthukumar N: Chronic spontaneous spinal epidural hematoma -- a rare cause of cervical myelopathy. Eur Spine J. 12(1):100-3, 2003
                                            14. Steinmetz MP et al: Successful surgical management of a case of spontaneous epidural hematoma of the spine during pregnancy. Spine J. 3(6):539-42, 2003
                                            15. Uribe J et al: Delayed postoperative spinal epidural hematomas. Spine J. 3(2):125-9, 2003
                                            16. Allison EJ Jr et al: Spinal epidural haematoma as a result of warfarin/fluconazole drug interaction. Eur J Emerg Med. 9(2):175-7, 2002
                                            17. Clark MA et al: Spinal epidural hematoma complicating thrombolytic therapy with tissue plasminogen activator--a case report. J Emerg Med. 23(3):247-51, 2002
                                            18. Dardik A et al: Subdural hematoma after thoracoabdominal aortic aneurysm repair: an underreported complication of spinal fluid drainage? J Vasc Surg. 36(1):47-50, 2002
                                            19. Houten JK et al: Paraplegia after lumbosacral nerve root block: report of three cases. Spine J. 2(1):70-5, 2002
                                            20. Ravid S et al: Spontaneous spinal epidural hematoma: an uncommon presentation of a rare disease. Childs Nerv Syst. 18(6-7):345-7, 2002
                                            21. Reitman CA et al: Subdural hematoma after cervical epidural steroid injection. Spine. 27(6):E174-6, 2002
                                            22. Stoll A et al: Epidural hematoma after epidural block: implications for its use in pain management. Surg Neurol. 57(4):235-40, 2002
                                            23. Sung JM et al: Acute spontaneous spinal epidural hematoma in a hemodialysis patient with a bleeding tendency. Nephron. 91(2):358-60, 2002
                                            24. Tseng SH et al: Cervical epidural hematoma after spinal manipulation therapy: case report. J Trauma. 52(3):585-6, 2002
                                            25. Uber-Zak LD et al: Neurologic complications of sit-ups associated with the Valsalva maneuver: 2 case reports. Arch Phys Med Rehabil. 83(2):278-82, 2002
                                            26. Holtås S et al: Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation. Radiology. 199(2):409-13, 1996
                                            27. Gundry CR et al: Epidural hematoma of the lumbar spine: 18 surgically confirmed cases. Radiology. 187(2):427-31, 1993
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Spinal epidural hematoma (SEH)

                                                        • Definitions

                                                          • Posttraumatic accumulation of blood into spinal epidural space

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Angiographic Findings

                                                                • Nonvascular Interventions

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Gross Pathologic & Surgical Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Domenicucci M et al: Spinal epidural hematomas: personal experience and literature review of more than 1000 cases. J Neurosurg Spine. 27(2):198-208, 2017
                                                                                      2. Wolf M et al: Neuroimaging of the traumatic spine. Magn Reson Imaging Clin N Am. 24(3):541-61, 2016
                                                                                      3. Giugale JM et al: Traumatic brachial plexus root avulsion and cervical spine epidural hematoma in an 18 year old male. Spine J. 15(2):365-6, 2015
                                                                                      4. Pérez-Bovet J et al: Traumatic epidural retroclival hematoma with odontoid fracture and cardiorespiratory arrest. Spinal Cord. 51(12):926-8, 2013
                                                                                      5. Rangarajan V et al: Traumatic cervical epidural hematoma in an infant. J Craniovertebr Junction Spine. 4(1):37-9, 2013
                                                                                      6. Kiran NA et al: Two children with traumatic thoracic spinal epidural hematoma. J Clin Neurosci. 16(10):1356-8, 2009
                                                                                      7. Groen RJ: Non-operative treatment of spontaneous spinal epidural hematomas: a review of the literature and a comparison with operative cases. Acta Neurochir (Wien). 146(2):103-10, 2004
                                                                                      8. Kirwan R et al: Nontraumatic acute and subacute enhancing spinal epidural hematoma mimicking a tumor in a child. Pediatr Radiol, 2004
                                                                                      9. Liao CC et al: Experience in the surgical management of spontaneous spinal epidural hematoma. J Neurosurg. 100(1 Suppl):38-45, 2004
                                                                                      10. Chang FC et al: Contrast enhancement patterns of acute spinal epidural hematomas: a report of two cases. AJNR Am J Neuroradiol. 24(3):366-9, 2003
                                                                                      11. Kreppel D et al: Spinal hematoma: a literature survey with meta-analysis of 613 patients. Neurosurg Rev. 26(1):1-49, 2003
                                                                                      12. Lang SA et al: Spinal epidural hematoma and epidural analgesia. Can J Anaesth. 50(4):422-3, 2003
                                                                                      13. Muthukumar N: Chronic spontaneous spinal epidural hematoma -- a rare cause of cervical myelopathy. Eur Spine J. 12(1):100-3, 2003
                                                                                      14. Steinmetz MP et al: Successful surgical management of a case of spontaneous epidural hematoma of the spine during pregnancy. Spine J. 3(6):539-42, 2003
                                                                                      15. Uribe J et al: Delayed postoperative spinal epidural hematomas. Spine J. 3(2):125-9, 2003
                                                                                      16. Allison EJ Jr et al: Spinal epidural haematoma as a result of warfarin/fluconazole drug interaction. Eur J Emerg Med. 9(2):175-7, 2002
                                                                                      17. Clark MA et al: Spinal epidural hematoma complicating thrombolytic therapy with tissue plasminogen activator--a case report. J Emerg Med. 23(3):247-51, 2002
                                                                                      18. Dardik A et al: Subdural hematoma after thoracoabdominal aortic aneurysm repair: an underreported complication of spinal fluid drainage? J Vasc Surg. 36(1):47-50, 2002
                                                                                      19. Houten JK et al: Paraplegia after lumbosacral nerve root block: report of three cases. Spine J. 2(1):70-5, 2002
                                                                                      20. Ravid S et al: Spontaneous spinal epidural hematoma: an uncommon presentation of a rare disease. Childs Nerv Syst. 18(6-7):345-7, 2002
                                                                                      21. Reitman CA et al: Subdural hematoma after cervical epidural steroid injection. Spine. 27(6):E174-6, 2002
                                                                                      22. Stoll A et al: Epidural hematoma after epidural block: implications for its use in pain management. Surg Neurol. 57(4):235-40, 2002
                                                                                      23. Sung JM et al: Acute spontaneous spinal epidural hematoma in a hemodialysis patient with a bleeding tendency. Nephron. 91(2):358-60, 2002
                                                                                      24. Tseng SH et al: Cervical epidural hematoma after spinal manipulation therapy: case report. J Trauma. 52(3):585-6, 2002
                                                                                      25. Uber-Zak LD et al: Neurologic complications of sit-ups associated with the Valsalva maneuver: 2 case reports. Arch Phys Med Rehabil. 83(2):278-82, 2002
                                                                                      26. Holtås S et al: Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation. Radiology. 199(2):409-13, 1996
                                                                                      27. Gundry CR et al: Epidural hematoma of the lumbar spine: 18 surgically confirmed cases. Radiology. 187(2):427-31, 1993