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Thread: Spontaneous bleed

  1. #1
    Senior Member keps's Avatar
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    Spontaneous bleed

    I am 28, and some months ago was paralyzed at
    t2(complete) by what was called a spontaneous spinal extradural haematoma. Has anyone else on here had this, or know someone who has? Is this the same as a spinal stroke? I'd really appreciate any information any has on this.It's very rare, I'm told, so I can't really find much info on this. Thanks in advance for anyone who can elighten me!

  2. #2
    Spontaneous hemorrhage (bleed) into the spinal cord is uncommon but also not rare. According to the following article from Japan, a literature review suggests that over 500 such cases have reported (and many more probably have not been reported). There is controversy concerning whether it should be decompressed surgically. Although previous reports recommended that it be decompressed within 48 hours, this paper suggested that many patients that are decompressed more than 48 hours after injury also showed good neurological recovery. It suggests that conservative approaches be taken in patients who are showingg rapid recovery, that decompression should be carried out as soon as possible, but decompression can be beneficial even when carried out more than 48 hours after injury. What is impressive, however, is the substantial amount of recovery in over 90% of patients.

    Shimada N, Sugawara T, Itoh Y, Hirano Y, Higashiyama N, Kinouchi H and Mizoi K (2005). [Four cases of spontaneous spinal epidural hematoma]. No Shinkei Geka 33: 163-8. Spontaneous spinal epidural hematoma (SSEH) is a rare clinical entity. Although approximately 500 cases have been reported, controversy exists concerning timing of the treatment and the validity of decompression surgery. We recently encountered four cases of SSEH. Evacuation of the hematoma was carried out in two patients with severe or persistent neurological deficits. Other two patients were treated conservatively because of the rapid resolution of the symptoms. All four patients improved after the treatment; three patients fully recovered and one patient required rehabilitation for moderate quadriparesis. Many previous reports recommended decompression surgery within 48 hours after the onset, however, one patient in our series fully recovered after surgery 4 days after the onset. We reviewed 183 operative cases of SSEH with incomplete neurological deficits in the literature and found that 93% of the patients who underwent surgery more than 48 hours after symptom onset showed good neurological recovery. Conservative treatment should be undertaken for rapidly improving patients, but surgical intervention should be considered in symptomatic patients regardless of the time from the onset. Department of Neurosurgery, Akita University School of Medicine, Japan. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&li st_uids=15714962

  3. #3
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    Hi Keps,
    My daughter Emma suffered a spontaneous epidural hematoma 2 1/2 years ago, at the time she was 3 1/2. It is particulary hard to understand because there is no reason for it, it just happened. Emma is now a T3 complete. She is doing very well considering everything she has gone through. Although this has changed our lives it has not changed Emma, she is still the same beautiful, funny and smart child she's always been and just seeing her every day makes our lives better. I hope it's the same for you and your family.

  4. #4
    Senior Member keps's Avatar
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    Thanks Akaltz and Wise Young,
    your responses were interesting and helpful.
    I didn't realize that SSEH could occur in someone so young, Akaltz.Sounds like you are all doing fine, which is great.
    I was surprised that surgery is not always considered the best treatment for SSEH, Wise.
    In my case, I believe my bleed would only have got worse (the doctors said I could've died without swift decompression surgery - my bleed was huge, apparently).
    One morning, I was woken by bad chest pain; this kept worsening until it was agony. Then, all of a sudden my legs were completely paralyzed. I was taken to hospital, where the paralysis crept up to my chest. I think the paralysis would've kept going up had I not been operated on.(An MRI scan had shown something on my spine. The doctors must've considered surgery urgent too, as I was operated on the same day this all happened.
    If you don't mind me asking, Akaltz, how did your daughter's bleed progress?
    Thanks again for both of your responses.
    Keps.

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