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    [Clinical Manifestations of Spinal Epidural Hematoma-Stroke Mimic and Pitfalls in Diagnosis].
    Brain Nerve 2017 Feb;69(2):119-128
    Department of Neurology, Brain Attack Center, Ota Memorial Hospital.
    Clinical manifestations of spinal epidural hematoma are presented, and the cases mimicking acute ischemic stroke have been reviewed from the literature. Many reports described the cases of spinal epidural hematoma with acute hemiparesis mimicking ischemic stroke in which intravenous thrombolytic treatment with recombinant tissue plasminogen activator was considered. A correct diagnosis of acute ischemic stroke must be made within 4. Read More

    Development and Internal Validation of a Clinical Risk Score for Treating Children With Mild Head Trauma and Intracranial Injury.
    JAMA Pediatr 2017 Feb 13. Epub 2017 Feb 13.
    Department of Neurosurgery, Washington University School of Medicine in St Louis, St Louis, Missouri.
    Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use.

    Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Read More

    Cervical spine imaging for young children with inflicted trauma: Expanding the injury pattern.
    J Pediatr Surg 2017 Jan 30. Epub 2017 Jan 30.
    Division of Pediatric Neurosurgery, Loma Linda University Children's Hospital, Loma Linda, CA.
    Aim: The purpose of this study was to document the incidence and pattern of cervical spine (c-spine) injuries in children below 36months with inflicted trauma.

    Methods: An IRB approved, prospective cohort study was performed between July 2011 and January 2016. Inclusion criteria were: age below 36months, loss of consciousness after inflicted trauma, and one initial head computed tomography finding: a subdural, intraventricular, intraparenchymal, subarachnoid hemorrhage, diffuse axonal injury, hypoxic injury, or cerebral edema. Read More

    Diagnosis and management of spinal cord emergencies.
    Handb Clin Neurol 2017 ;140:319-335
    Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. Electronic address:
    Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. Read More

    Cranioplasty with autogenous bone flaps cryopreserved in povidone iodine: a long-term follow-up study.
    J Neurosurg 2017 Feb 10:1-8. Epub 2017 Feb 10.
    Department of Neurosurgery, Linyi People's Hospital, Linyi.
    OBJECTIVE The aim of this study was to investigate the long-term therapeutic efficacy of cranioplasty with autogenous bone flaps cryopreserved in povidone iodine and explore the risk factors for bone resorption. METHODS Clinical data and follow-up results of 188 patients (with 211 bone flaps) who underwent cranioplasty with autogenous bone flaps cryopreserved in povidone-iodine were retrospectively analyzed. Bone flap resorption was classified into 3 types according to CT features, including bone flap thinning (Type I), reduced bone density (Type II), and osteolysis within the flaps (Type III). Read More

    Subdural hematoma as a major determinant of short-term outcomes in traumatic brain injury.
    J Neurosurg 2017 Feb 10:1-14. Epub 2017 Feb 10.
    Warren Alpert Medical School of Brown University.
    OBJECTIVE Early radiographic findings in patients with traumatic brain injury (TBI) have been studied in hopes of better predicting injury severity and outcome. However, prior attempts have generally not considered the various types of intracranial hemorrhage in isolation and have typically not excluded patients with potentially confounding extracranial injuries. Therefore, the authors examined the associations of various radiographic findings with short-term outcome to assess the potential utility of these findings in future prognostic models. Read More

    Management of a Patient Requiring Intrathecal Drain Insertion and Removal in the Setting of Concomitant Dual Antiplatelet Therapy With Clopidogrel and Aspirin: A Case Report.
    A A Case Rep 2017 Feb 8. Epub 2017 Feb 8.
    From the Department of Anesthesiology and Pain Management, Maine Medical Center, Portland, Maine.
    We report a case of deliberate intrathecal catheter insertion and removal in the setting of continuous dual-antiplatelet therapy with clopidogrel and aspirin. A patient with recently sited bare metal intracerebral stents developed severe symptomatic hydrocephalus and required temporary cerebrospinal fluid diversion. The risks of intracerebral in-stent thrombosis or delayed intervention precluded following guidelines for the management of clopidogrel in neuraxial procedures. Read More

    Treatment of iatrogenic V2 segment vertebral artery pseudoaneurysm using Pipeline flow-diverting stent.
    Surg Neurol Int 2016 20;7:104. Epub 2016 Dec 20.
    Department of Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA; Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA; Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, New York, USA.
    Background: Iatrogenic injury to the vertebral artery is a rare but potential complication of cervical spine surgery. Previous authors have commented on the use of flow-diverting stents for treatment of aneurysms of the V3 segment of the vertebral artery.

    Case Description: Here, we report a case in which injury occurred at the V2 segment of the vertebral artery with the development of a pseudoaneurysm, which was found on angiography. Read More

    Anatomical complications of epidural anesthesia: A comprehensive review.
    Clin Anat 2017 Feb 6. Epub 2017 Feb 6.
    Epidural anesthesia is a versatile technique widely used in treating lumbar spinal pain syndromes. Complications during these procedures can arise either from needle placement or from administration of medication. Potential risks include infection, hematoma, intravascular or subdural injections of medication, direct nerve trauma, air embolism, entry into a disc space, urinary retention, radiation exposure, and hypersensitivity reactions. Read More

    Management of acute spontaneous thoracic spinal epidural hematoma causing paraplegia.
    Med Glas (Zenica) 2017 Feb;14(1):106-110
    Department of Neurology, Cantonal Hospital Zenica; Bosnia and Herzegovina.
    Aim To emphasize the importance of early recognition, diagnostic processing and emergent surgical treatment of spontaneous spinal epidural hematoma (SSEH). Methods A 39-year-old female presented with sudden onset of severe pain between the shoulder blades followed by paraparesis and alerted sensibility in the lower extremities. An hour later she developed paraplegia with sensory deficits below ThIV level, absence of patellar reflex, ankle jerk reflex and sphincter dysfunction. Read More

    Contralateral interlaminar keyhole percutaneous endoscopic surgery in patients with unilateral radiculopathy: technical notes.
    World Neurosurg 2017 Jan 30. Epub 2017 Jan 30.
    Department of Neurosurgery, Daejeon Woori Hospital, Daejeon, Korea. Electronic address:
    Objective: Percutaneous endoscopic surgery is increasingly used as an alternative to open microsurgery for treating lumbar spinal diseases. The purpose of this study was to determine the feasibility and efficacy of contralateral keyhole endoscopic surgery (CKES) for treating unilateral radiculopathy.

    Methods: We performed percutaneous endoscopic sublaminar decompression via the contralateral interlaminar approach in 14 patients with unilateral radiculopathy. Read More

    Isolated internuclear ophthalmoplegia after massive supratentorial epidural hematoma: a case report and review of literature.
    World Neurosurg 2017 Jan 28. Epub 2017 Jan 28.
    Division of Neurosurgery, Department of Surgery, Saint Paul's hospital, Taoyuan, Taiwan.
    Background: Isolated Internuclear ophthalmoplegia (INO) following traumatic brain injury (TBI) is rare, with the majority of reported patients suffering from minor head injuries. We report a patient with INO after a massive supratentorial epidural hematoma. We review the literature published since 1966, to summarize the mechanisms of injury and clinical outcomes of INO after TBI. Read More

    Serratus anterior plane block for hybrid transthoracic esophagectomy: a pilot study.
    J Pain Res 2017 4;10:73-77. Epub 2017 Jan 4.
    Department of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, Milano, Italy.
    Background: Pain is a major limiting factor in patient's recovery from major thoracic surgical procedures. Thoracic epidural analgesia (TEA), the current gold standard of perioperative management, has contraindications, can technically fail, and carries a risk of complications such as epidural abscess and spinal hematoma. The ultrasound-guided serratus anterior plane (SAP) block is a promising regional analgesia technique. Read More

    Innovative Technique for the Placement of the Drainage Tube for Microendoscopic Spinal Decompression.
    Clin Spine Surg 2017 Feb;30(1):E59-E63
    Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
    Study Design: A technical note and retrospective study.

    Objectives: The objectives were to describe a new method of drainage tube placement during microendoscopic spinal decompression, and compare the positioning and fluid discharge obtained with this method and the conventional method.

    Summary Of Background Data: To prevent postoperative epidural hematoma after microendoscopic decompression, a drainage tube must be placed in a suitable location. Read More

    Myelopathy in adult aortic coarctation: Causes and caveats of an atypical presentation.
    Indian J Radiol Imaging 2016 Oct-Dec;26(4):451-454
    Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
    A 57-year-old female presenting with acute-onset paraplegia was referred for magnetic resonance imaging (MRI) of cervico-dorsal spine. On MRI, multiple tortuous dilated vessels were noted in the epidural space with long segment cord compression and imaging features of compressive myelopathy. Associated small acute cervico-dorsal epidural hematoma was also noted in the same region. Read More

    Intravenous Tissue Plasminogen Activator Administration for Ischemic Stroke 1 Hour After Epidural Catheter Removal: A Case Report.
    A A Case Rep 2017 Jan 11. Epub 2017 Jan 11.
    From the *VA Puget Sound Health Care System, Department of Pharmacy, University of Washington, Seattle, Washington; †Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; ‡VA Puget Sound Health Care System, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; and §VA Puget Sound Health Care System, Department of Neurology, University of Washington, Seattle, Washington.
    Anticoagulation after a recent neuraxial procedure poses risk for development of spinal hematoma. Clinical evidence supports prompt IV tissue plasminogen activator administration after onset of ischemic stroke. There is an absence of data regarding emergency fibrinolytic therapy for patients experiencing a stroke with recent neuraxial procedures, resulting in highly disparate, nonevidence-based guidelines. Read More

    Recognition of a Thoracic Epidural Hematoma in the Setting of Transient Paralysis: A Case Report.
    A A Case Rep 2017 Jan 11. Epub 2017 Jan 11.
    From the Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
    A 71-year-old woman on aspirin presented for a distal pancreatectomy, splenectomy, and partial colectomy with a T8/9 epidural catheter placed preoperatively in 3 attempts. Prophylactic 5000 units of subcutaneous heparin were given before the procedure. After catheter removal on postoperative day 2, the patient developed transient bilateral lower extremity paralysis, with near complete recovery within 30 minutes. Read More

    Spontaneous Intracranial Hypotension With Site of Leak Detected Only After 111In-DTPA Cisternogram.
    Clin Nucl Med 2017 Jan 10. Epub 2017 Jan 10.
    From the Departments of *Radiology, and †Nuclear Medicine, University of Washington, Seattle, WA.
    A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. Read More

    Clinical evaluation of post-operative cerebral infarction in traumatic epidural haematoma.
    Brain Inj 2017 5;31(2):215-220. Epub 2017 Jan 5.
    a Department of Neurosurgery , Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , PR China.
    Background: Patients with traumatic epidural haematoma, undergoing the prompt and correct treatment, usually have favourable outcomes. However, secondary cerebral infarction may be life-threatening condition, as it is difficult to be identified before neurological impairment occurs.

    Objective: To evaluate the clinical data of patients with traumatic EDH and assess potential risk factors for post-operative cerebral infarction. Read More

    Inpatient rehabilitation following operative spontaneous spinal epidural hematoma mimicking stroke: a case report.
    Spinal Cord Ser Cases 2016 7;2:16007. Epub 2016 Jul 7.
    Department of Physical Medicine and Rehabilitation, University District Hospital, University of Puerto Rico School of Medicine , San Juan, Puerto Rico.
    Spontaneous spinal epidural hematoma (SSEH) is a rare cause of spinal cord compression. Symptoms may include sudden-onset axial pain followed by neurologic involvement including weakness, numbness and incontinence. Here we report the case of a patient followed prospectively after surgical intervention following SSEH and recovery following inpatient rehabilitation. Read More

    Intracranial epidural hemorrhage during lumbar spinal surgery.
    Spinal Cord Ser Cases 2016 7;2:15040. Epub 2016 Apr 7.
    Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube City, Japan.
    The authors report a case of intracranial epidural hemorrhage (ICEH) during spinal surgery. We could not find ICEH, though we recorded transcranial electrical stimulation motor evoked potentials (TcMEPs). A 35-year-old man was referred for left anterior thigh pain and low back pain that hindered sleep. Read More

    Children presenting in delayed fashion after minor head trauma with scalp swelling: do they require further workup?
    Childs Nerv Syst 2017 Jan 3. Epub 2017 Jan 3.
    Department of Neurosurgery, Baylor College of Medicine, Division of Pediatric Neurosurgery, Texas Children's Hospital, Houston, TX, USA.
    Purpose: It is common to evaluate children who have sustained minor head trauma with computed tomography (CT) of the head. Scalp swelling, in particular, has been associated with intracranial injury. A subset of patients, however, present in delayed fashion, often days after the head trauma, as soft tissue edema progresses and their caregiver notices scalp swelling. Read More

    Imaging of Intracranial Hemorrhage.
    J Stroke 2017 Jan 12;19(1):11-27. Epub 2016 Dec 12.
    Stanford University Hospital, Department of Radiology, Neuroimaging and Neurointervention Division, CA, USA.
    Intracranial hemorrhage is common and is caused by diverse pathology, including trauma, hypertension, cerebral amyloid angiopathy, hemorrhagic conversion of ischemic infarction, cerebral aneurysms, cerebral arteriovenous malformations, dural arteriovenous fistula, vasculitis, and venous sinus thrombosis, among other causes. Neuroimaging is essential for the treating physician to identify the cause of hemorrhage and to understand the location and severity of hemorrhage, the risk of impending cerebral injury, and to guide often emergent patient treatment. We review CT and MRI evaluation of intracranial hemorrhage with the goal of providing a broad overview of the diverse causes and varied appearances of intracranial hemorrhage. Read More

    Immediate Adverse Events in Interventional Pain Procedures: A Multi-Institutional Study.
    Pain Med 2016 Dec 15;17(12):2155-2161. Epub 2016 Apr 15.
    Department of Orthopedic Surgery, Stanford University, Stanford, California.
    Setting: Interventional procedures directed toward sources of pain in the axial and appendicular musculoskeletal system are performed with increasing frequency. Despite the presence of evidence-based guidelines for such procedures, there are wide variations in practice. Case reports of serious complications such as spinal cord infarction or infection from spine injections lack appropriate context and create a misleading view of the risks of appropriately performed interventional pain procedures. Read More

    The Impact of Diabetes Mellitus on Patients Undergoing Cervical Spondylotic Myelopathy: A Meta-Analysis.
    Eur Neurol 2017 21;77(1-2):105-112. Epub 2016 Dec 21.
    Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China.
    Aims: We conducted a meta-analysis of eligible studies to compare the surgical outcomes between diabetic patients and non-diabetic patients who have undergone cervical spondylotic myelopathy (CSM).

    Methods: A systematic literature search of PubMed, Embase, and Web of Science (up to February 10, 2016) was conducted. Eligible studies were case-control or cohort studies that compared the outcomes of cervical surgery between diabetic patients and non-diabetic patients. Read More

    Closed Drainage versus Non-Drainage for Single-Level Lumbar Disc Surgery: Relationship between Epidural Hematoma and Fibrosis.
    Asian Spine J 2016 Dec 8;10(6):1072-1078. Epub 2016 Dec 8.
    Department of Neurosurgery, Istanbul Arel University, Istanbul, Turkey.
    Study Design: A prospective clinical series with prospectively collected data.

    Purpose: The efficacy of using closed suction drains (CSD) after single-level lumbar disc surgery was evaluated. Postoperative CSD are regularly fitted to prevent postoperative epidural hematomas (EH) after multilevel lumbar decompression, although it remains unclear whether CSD also reduces postoperative EH following single-level lumbar disc surgery. Read More

    Spontaneous intracranial epidural hematoma during rivaroxaban treatment.
    Rev Assoc Med Bras (1992) 2016 Nov;62(8):721-724
    PhD, Head of the Neurosurgery Department, INC, Curitiba, PR, Brazil.
    According to our research, this is the first case described in the literature of spontaneous intracranial epidural hematoma secondary to the use of Xareltor. Spontaneous intracranial epidural hematomas are rarely described in the literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura mater and metastasis to the skull. Read More

    Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in multilevel cervical spondylotic myelopathy: A meta-analysis.
    Medicine (Baltimore) 2016 Dec;95(49):e5437
    aDepartment of Spinal Surgery, The Third Hospital of Hebei Medical University bHebei Provincial Key Laboratory of Orthopedic Biomechanics, Shijiazhuang, China.
    Background: Both anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are used to treat multilevel cervical spondylotic myelopathy (mCSM); however, which one is better treatment for mCSM remains considerable controversy. A meta-analysis was performed to compare clinical outcomes, radiographic outcomes, and surgical outcomes between ACDF and ACCF in treatment for mCSM.

    Methods: An extensive search of literature was performed in Pubmed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases on ACDF versus ACCF treatment for mCSM from January 2011 to August 2016. Read More

    Chronic spinal subdural hematoma associated with antiplatelet therapy: a case report.
    World Neurosurg 2016 Dec 3. Epub 2016 Dec 3.
    Department of Neurosurgery, Sapporo Medical University, Sapporo 003-0804, Japan.
    Background: Spinal subdural hematoma is a rare clinical entity marked by the onset of pain and paralysis, which is usually associated with hemorrhagic disorders, trauma, and iatrogenic causes such as lumbar puncture or epidural anesthesia.

    Case Presentation: A 71-year-old male was admitted to our hospital with 2 weeks' history of bilateral lower leg pain, dysesthesia, paraparesis, and urinary disturbance. Magnetic resonance imaging revealed characteristic findings at the thoracolumbar spine, and surgical evacuation successfully treated this condition. Read More

    Skull Subsidence due to Periosteum Defect following Craniotomy in a Child.
    Pediatr Neurosurg 2016 Dec 7. Epub 2016 Dec 7.
    Department of Neurosurgery, University of Fukui, Fukui, Japan.
    We report a case of a 7-year-old child with a cranial deformity secondary to a craniotomy for an intracranial hematoma. He suffered from an acute epidural hematoma with a lineal fracture of the right temporal bone following a severe head injury. A large question mark-shaped skin flap with the periosteum and temporal muscle was created for a decompressive craniectomy; however, neither the acute epidural hematoma nor brain swelling was severe, and we performed a small craniotomy compared with the skin flap without a decompressive craniectomy. Read More

    Infectious Postpartum Sacroiliitis: The Importance and Difficulty of Early Diagnosis.
    Acta Med Port 2016 Aug 31;29(7-8):484-487. Epub 2016 Aug 31.
    Serviço de Ginecologia e Obstetrícia. Hospital de Braga. Braga. Portugal.
    The sacroiliitis accounts for about 1.5% - 10% of all cases of septic arthritis and it is strongly associated with gynaecological infections, pelvic trauma or drug abuse (3.4% - 12. Read More

    Why Cannot Suction Drains Prevent Postoperative Spinal Epidural Hematoma?
    Clin Orthop Surg 2016 Dec 4;8(4):407-411. Epub 2016 Nov 4.
    Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.
    Background: Postoperative spinal epidural hematoma (POSEH) is different from spontaneous or post-spinal procedure hematoma because of the application of suction drains. However, it appeared that suction drains were not effective for prevention of POSEH in previous studies. The purpose of this study was to test our hypothesis that POSEH can be caused by hypercoagulability. Read More

    Spontaneous spinal epidural hematoma: a study of 55 cases focused on the etiology and treatment strategy.
    World Neurosurg 2016 Nov 24. Epub 2016 Nov 24.
    Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 100000 Beijing, China. Electronic address:
    Background: Spontaneous spinal epidural hematoma (SSEH) is a rare neurological emergency of the spinal cord. Its etiology and treatment strategy remain controversial. This study aimed to evaluate a significant cause of SSEH and to discuss the treatment strategy according to the clinical outcomes of patients in two institutions. Read More

    Clinical predictors of intracranial injuries in infants with minor head trauma.
    World Neurosurg 2016 Nov 19. Epub 2016 Nov 19.
    Department of Neurosurgery, Tokyo Women's Medical University Medical Center East.
    Objective: Minor head trauma is common in children. Though most cases are nonsignificant, minor head trauma can lead to the deterioration of intracranial injuries, which is preventable. The aim of this study was to identify clinical predictors of intracranial injuries in infants with minor head trauma. Read More

    Use of Prothrombin Complex Concentrate for Warfarin Reversal Before the Performance of an Epidural Blood Patch in a Patient With Cortical Vein Thrombosis and Subdural Hematoma: A Case Report.
    A A Case Rep 2017 Jan;8(2):36-38
    From the *Department of Anesthesiology, Texas Tech University Health Sciences Center, Lubbock, Texas; and †UT Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas.
    Compared to conventional therapy, several studies with prothrombin complex concentrate (PCC) have recently demonstrated its superior efficacy in rapidly replacing vitamin K-dependent factors for patients with life-threatening hemorrhage. We present a novel use of PCC in a patient with intracranial hypotension, who had received warfarin for treatment of cortical vein thrombosis. However, after anticoagulation, she proceeded to develop bilateral subdural hematomas with descent of cerebellar tonsils. Read More

    Effects of discontinuance of preoperative anti-platelet medication in multi-level thoracolumbar spine surgery.
    Turk Neurosurg 2016 Oct 14. Epub 2016 Oct 14.
    Pusan National University Yangsan Hospital.
    Aim: Our study aimed to evaluate the perioperative morbidities of patients taking anti-platelet medication prior to multi-level thoracolumbar spine surgery.

    Material And Methods: We retrospectively reviewed the medical records of 65 patients who underwent multi-level spine surgery from January 2009 to November 2014 at our institution. These patients were divided into two groups: the control group (n=45) did not take any anti-platelet medications prior to surgery; the anti-platelet group (n=20) discontinued the anti-platelet medication 7 days before the spine surgery. Read More

    Clinical Outcome of Acute Epidural Hematoma in Korea: Preliminary Report of 285 Cases Registered in the Korean Trauma Data Bank System.
    Korean J Neurotrauma 2016 Oct 31;12(2):47-54. Epub 2016 Oct 31.
    Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University, Wonju, Korea.
    Objective: The aim of this preliminary collaborative study was to assess the clinical characteristics, management, and outcome of epidural hematoma (EDH) based on the data collected and registered in the Korean Trauma Data Bank System (KTDBS).

    Methods: Of 2,698 patients registered in the KTDBS between September 2010 and March 2014, 285 patients with EDH were analyzed. Twenty-three trauma centers participated in the study voluntarily to collect data. Read More

    Imaging in spinal posterior epidural space lesions: A pictorial essay.
    Indian J Radiol Imaging 2016 Jul-Sep;26(3):299-315
    Department of Radiology, TNMC and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India.
    Spinal epidural space is a real anatomic space located outside the dura mater and within the spinal canal extending from foramen magnum to sacrum. Important contents of this space are epidural fat, spinal nerves, epidural veins and arteries. Due to close proximity of posterior epidural space to spinal cord and spinal nerves, the lesions present with symptoms of radiculopathy and/or myelopathy. Read More

    Spontaneous intracranial hypotension complicated by malignancyinduced disseminated intravascular coagulation: A case report.
    Acta Neurol Taiwan 2016 Sep;25(3):95-98
    Department of Neurology, Neurological Institute; Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.
    Purpose: Spontaneous intracranial hypotension (SIH) is a rare type of headache. The association of SIH with malignancy and disseminated intravascular coagulation (DIC) has not previously been reported.

    Case Report: A 60-year-old woman had orthostatic headache for more than one month before admission. Read More

    Acute Cervical Spontaneous Spinal Epidural Hematoma Presenting with Minimal Neurological Deficits: A Case Report.
    Anesth Pain Med 2016 Oct 27;6(5):e40067. Epub 2016 Aug 27.
    Department of Anesthesiology and Pain medicine, Jeju National University Hospital, School of medicine, Jeju National University, Jeju, South Korea.
    Introduction: Spontaneous spinal epidural hematoma (SSEH) is an uncommon but potentially fatal condition. The increased bleeding tendency associated with anticoagulant medications has been proven to increase the risk of SSEH. The symptoms of SSEH usually begin with sudden severe neck or back pain and are followed by neurological deficits. Read More

    Postoperative Cerebrospinal Fluid Leak Rates with Subfascial Epidural Drain Placement after Intentional Durotomy in Spine Surgery.
    Global Spine J 2016 Dec 13;6(8):780-785. Epub 2016 Apr 13.
    Department of Neurosurgery, University of California, Los Angeles, California, United States; Brain Research Institute, University of California, Los Angeles, California, United States.
    Study Design Retrospective chart review. Objective Postoperative cerebrospinal fluid (CSF) leak is a known complication of intraoperative durotomy. Intraoperative placement of subfascial epidural drains following primary dural repair has been proposed as a potential management strategy to prevent formation of CSF cutaneous fistula and symptomatic pseudomeningocele. Read More

    Reversible cerebral vasoconstriction syndrome and posterior reversible encephalopathy syndrome associated with intracranial hypotension.
    Neurocrit Care 2017 Feb;26(1):103-108
    Department of Neurology, University Hospital, Campus Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany.
    Background: Reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES) are both rare disorders. The pathophysiology of both diseases is not yet fully understood.

    Methods: We report the unique case of a 19-year-old comatose woman who was brought to the ER after a series of generalized tonic-clonic seizures 6 days post peridural anesthesia for cesarean section. Read More

    Large, spontaneous spinal subdural-epidural hematoma after epidural anesthesia for caesarean section: Conservative management with excellent outcome.
    Surg Neurol Int 2016 22;7(Suppl 25):S664-S667. Epub 2016 Sep 22.
    Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, USA; Department of Neurosurgery, Kaleida Health, Buffalo, New York, USA.
    Background: Iatrogenic or spontaneous spinal hematomas are rarely seen and present with multiple symptoms that can be difficult to localize. Most spontaneous spinal hematomas are multifactorial, and the pathophysiology is varied. Here, we present a case of a scattered, multicomponent, combined subdural and epidural spinal hematoma that was managed conservatively. Read More

    Quantitative estimation of a ratio of intracranial cerebrospinal fluid volume to brain volume based on segmentation of CT images in patients with extra-axial hematoma.
    Neuroradiol J 2017 Feb 11;30(1):10-14. Epub 2016 Nov 11.
    Department of Neurosurgery, Medical College of Wisconsin, USA.
    Background Diminishing volume of intracranial cerebrospinal fluid (CSF) in patients with space-occupying masses have been attributed to unfavorable outcome associated with reduction of cerebral perfusion pressure and subsequent brain ischemia. Objective The objective of this article is to employ a ratio of CSF volume to brain volume for longitudinal assessment of space-volume relationships in patients with extra-axial hematoma and to determine variability of the ratio among patients with different types and stages of hematoma. Patients and methods In our retrospective study, we reviewed 113 patients with surgical extra-axial hematomas. Read More

    Successful treatment of traumatic spinal epidural haematoma with fluoroscopically-guided percutaneous drainage: a report of two cases.
    Anaesth Intensive Care 2016 Nov;44(6):777-780
    Professor, Department of Emergency and Critical Care Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
    We report two cases of spinal epidural haematoma that were successfully treated with percutaneous drainage. The patients initially presented with severe backache and progressive neurological symptoms due to traumatic epidural haematoma. After fluoroscopically-guided percutaneous drainage and irrigation, rapid physical decompression and full recovery was observed in both patients. Read More

    Postoperative Symptomatic Anterior Spinal Epidural Hematoma: Complete Drainage Using Corpectomy and a Bladder Catheter.
    Spine (Phila Pa 1976) 2016 Nov;41(22):E1368-E1371
    *Department of Orthopedic Surgery and Traumatology, Spine Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain †Department of Orthopedic Surgery and Traumatology, Hospital Universitario 12 de Octubre, Madrid, Spain ‡Department of Orthopaedic Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
    Study Design: A case report.

    Objective: We describe a technique to drain a thoracic and cervical postoperative epidural hematoma causing paraplegia after anterior cervical discectomy and fusion.

    Summary Of Background Data: Postoperative compressive spinal epidural hematoma (SEH) is a devastating complication and early diagnosis and treatment is essential. Read More

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