Türk Nöroşirürji Dergisi 2019 , Vol 29 , Num 1
Surgical Management of Spinal Epidural and Subdural Hematoma
Gökhan ÇAVUŞ1,Emre BİLGİN1
1Adana Şehir Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Adana, Türkiye Spinal subdural hematoma and spinal epidural hematoma are very rare complications that can develop very quickly. The etiology depends on the location. The most common cause of bleeding is trauma. Vascular malformations and bleeding diuresis are the most common causes of non-traumatic bleeding affecting the spinal cord. Depending on the level at which the spinal cord is affected, they present with pain and neurological deficit. In addition to intestinal or bladder disorders caused by cord compression at the level of the hematoma, motor loss and sensory loss occur below the bleeding level. Diagnosis and differential diagnosis is possible with computed tomography (CT) and magnetic resonance imaging (MRI).Acute hematoma is hyperdense on CT within the first few hours. T1, T2, Gradient echo and diffusion weighted sequences are used to differentiate the hematoma. In MRI, acute hematoma is hyperintense in T1. Surgical evacuation of spinal hematomas causing acute progressive neurological deficits is necessary. Acute hematomas that do not cause neurological deficits should be monitored with MRI. In case of a sudden deterioration of neurological status during follow-up, surgical intervention should be performed without delay. The hematoma that has a compressive effect should be evacuated and the pressure effect should be eliminated. Otherwise, the developing neurological deficit will become permanent. Anahtar Kelimeler : Spinal, Epidural, Subdural, Hematoma, Surgery