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Neurology 2022 Jun 17. Epub 2022 Jun 17.

Department of Neurosurgery, The 2nd Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China

Objective: Spontaneous spinal epidural hematoma (SSEH) is an uncommon but serious condition with a high morbidity rate. Although SSEH is related to numerous risk factors, its etiology remains unclear. There is a paucity of data on its prognostic factors. Read More

JBJS Case Connect 2022 04 8;12(2). Epub 2022 Jun 8.

Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

Case: A 44-year-old man developed urinary retention due to a spontaneous spinal epidural hematoma (SSEH) at the cervicothoracic junction, without paraplegia. Symptoms improved with surgical treatment.

Conclusion: SSEH is rare and causes acute neck or back pain and progressive paralysis. Read More

Case Rep Orthop 2022 2;2022:7548593. Epub 2022 Jun 2.

Department of Orthopedics, Mayo Clinic Arizona, USA.

Introduction: This case report adds to current literature on management of a subdural hematoma following total knee arthroplasty and is particularly important as joint replacement moves into outpatient surgery centers where the orthopedic surgery team becomes the sole patient contact point. . A 66-year-old male presented to the emergency department five days after elective robotic-assisted left total knee arthroplasty performed with spinal epidural with the symptoms of a persistent nonpostural headache. Read More

Phys Sportsmed 2022 Jun 13:1-8. Epub 2022 Jun 13.

Department of Sports Medicine, Orthopedic Specialists of North Carolina, Raleigh NC, USA.

Professional boxing, kickboxing, and mixed martial arts (MMA) are popular sports with substantial risk for both acute and chronic traumatic brain injury (TBI). Although rare, combat sports athletes have died in the ring or soon after the completion of a bout. Deaths in these instances are usually the result of an acute catastrophic neurological event such as an acute subdural hematoma (SDH). Read More

Medicine (Baltimore) 2022 Jun 3;101(22):e29340. Epub 2022 Jun 3.

Department of Spine Surgery, Fuzhou Second Hospital, The Third Clinical Medical College, Fujian Medical University, Fuzhou, China.

Rationale: Osteoporotic vertebral compression fracture (OVCF) accompanying huge spinal epidural hematoma (SEH) is fairly rare. The aim of this report is to investigate the management strategies and treatment outcomes of OVCF accompanying SEH.

Patient Concerns: An 89-year-old female patient was admitted to hospital because of severe back pain and numbness of both lower limbs after a slight fall. Read More

World Neurosurg 2022 May 30. Epub 2022 May 30.

Department of Neurosurgery, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Background: Necessity of computed tomography (CT) has been questioned in pediatric mTBI due to concerns related to radiation exposure. Distinguishing patients with lower and higher risk of clinically important TBI (ciTBI) is paramount to the optimal management of these patients.

Objective: This study aimed to analyze the imaging predictors of ciTBI, and develop an algorithm to identify patients at low and high risk for ciTBI to inform clinical decision-making using a large single-center cohort of pediatric mTBI patients. Read More

Ulus Travma Acil Cerrahi Derg 2022 Jun;28(6):805-811

Department of Neurosurgery, İstanbul University Istanbul Faculty of Medicine, İstanbul-Turkey.

Background: Supratentorial midline epidural hematoma is rare but challenging in diagnosis and management. Indication for surgery can arise even following hospital admission. Being familiar to the presentation and watching out for direct and indirect signs on axial computed tomography (CT) such as suture diastasis or fracture traversing midline are essential to plan multi-planar CT enabling exact diagnosis including form and mass effect of hematoma. Read More

Cureus 2022 Apr 26;14(4):e24492. Epub 2022 Apr 26.

Radiology, St. John's Medical College, Bangalore, IND.

Epidural hematoma (EDH) classically occurs secondary to trauma. Spontaneous EDH is uncommon and can be a rare complication of sickle cell disease (SCD). We report the case of a 20-year-old Indian male with sickle cell anemia, who presented with a sickling bony crisis and suffered a non-traumatic EDH within 24 hours of admission. Read More

BMC Musculoskelet Disord 2022 May 30;23(1):508. Epub 2022 May 30.

Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.

Background: Chronic spinal epidural hematomas (SEHs) are rare clinical entities. SEH with vertebral scalloping is extremely rare, with only a few cases having been reported to date. We report a unique case of spontaneous chronic SEH in the lumbar spine with severe vertebral scalloping mimicking an epidural tumor. Read More

Am Surg 2022 06 16;88(6):1328-1329. Epub 2020 Aug 16.

3577 Department of Surgery, Trauma Section, Ascension Genesys Hospital, Grand Blanc, MI, USA.

Cureus 2022 Apr 7;14(4):e23915. Epub 2022 Apr 7.

Neurosurgery, Toyohashi Municipal Hospital, Toyohashi, JPN.

Spinal epidural hematoma is a rare disease that may present as motor paralysis, sensory disturbance, and a sudden radiating pain from the hematoma site. Herein, we report two cases of cervical epidural hematoma diagnosed as left hemiplegia and treated with surgery. Case 1 was a 62-year-old woman who presented to our hospital with the chief complaint of posterior neck pain and left upper and lower limb paralysis. Read More

Am J Emerg Med 2022 Jul 28;57:160-161. Epub 2022 Apr 28.

Department of Diagnostic Imaging, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.

Neurochirurgie 2022 May 1. Epub 2022 May 1.

Department of Orthopaedic and Traumatological Surgery, Beaujon/Bichat Hospitals, APHP. Nord University of Paris, Clichy, France.

Symptomatic cervical hematoma (CH) after cervical spine surgery through an anterolateral approach is a feared complication. In up to 60% of CH cases, no source of bleeding is detected during drainage. Bleeding from the pin holes of the Caspar distractor is a known complication, briefly mentioned in the patent, but harmfulness has never been thoroughly assessed. Read More

Clin Neurol Neurosurg 2022 06 19;217:107258. Epub 2022 Apr 19.

Department of Neurosurgery, Kirsehir Ahi Evran University Faculty of Medicine, Kirsehir, Turkey. Electronic address:

Objective: Determining the bleeding time in intracranial hemorrhage patients is one of the most critical parameters in determining the surgical or medical treatment method. Since these are trauma patients, they are essential patients in forensic medicine. In patients where the bleeding time cannot be determined, HU value measurements in CT scans can provide quantitative data. Read More

Cureus 2022 Mar 27;14(3):e23532. Epub 2022 Mar 27.

Emergency Medicine, Hospital Corporation of America (HCA) Florida Ocala Hospital, Ocala, USA.

Spontaneous spinal epidural hematomas (SSEHs) are neurological emergencies complicated by a wide array of presentations. In this study, we report a case of a patient who presented with neck pain and was diagnosed with an SSEH with computed tomography (CT) angiography with subsequent confirmation by magnetic resonance imaging (MRI). The high-risk location and size of the lesion guided management and surgical intervention. Read More

Comput Biol Med 2022 Jul 18;146:105530. Epub 2022 Apr 18.

Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. Electronic address:

The most common cause of long-term disability and death in young adults is a traumatic brain injury. The decision for surgical intervention for craniotomy is dependent on the injury type and the patient's neurologic exam. The potential subtypes of intracranial hemorrhage that may necessitate surgical intervention include subdural hemorrhage, epidural hemorrhage, and intraparenchymal hemorrhage. Read More

Front Med (Lausanne) 2022 25;9:832693. Epub 2022 Mar 25.

Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China.

Background: Spontaneous spinal epidural hematoma, without discernable underlying conditions, is considered a neurological emergency, and is rare during pregnancy.

Case Presentation: We report the case of a 24-year-old patient at 37 weeks of gestation. She had back pain that progressed to paraplegia of both lower limbs within 2 days. Read More

Eur J Case Rep Intern Med 2022 9;9(3):003218. Epub 2022 Mar 9.

Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, France.

We report the case of an 86-year-old female patient with chronic neck pain who presented with an initial misleading clinical picture suggesting an ischaemic stroke. No recent or previous anticoagulation treatment or fall history was reported. The patient developed a paraplegia of the upper limbs needing magnetic resonance imaging which revealed a compressive cervical haematoma. Read More

J Int Med Res 2022 Mar;50(3):3000605221082891

Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.

Spinal epidural hematomas are rare, with trauma being the most common cause. Spinal epidural hematomas caused by coagulation dysfunction are even rarer; however, long-term warfarin therapy increases the risk. The clinical manifestations of spinal epidural hematoma are neurological deficits below the corresponding spinal cord segment level. Read More

World J Clin Cases 2022 Feb;10(6):1863-1868

Department of Neurosurgery, West China Hospital, Chengdu 610041, Sichuan Province, China.

Background: Epidural hematoma is one of the common postoperative complications after craniotomy. However, multiple remote epidural hematomas in different sites, including supratentorial and infratentorial regions, are exceedingly rare.

Case Summary: We present a rare case in which three remote epidural hematomas occurred after craniotomy. Read More

Neurosurgery 2022 06 16;90(6):691-699. Epub 2022 Mar 16.

Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.

Background: When evaluating children with mild traumatic brain injuries (mTBIs) and intracranial injuries (ICIs), neurosurgeons intuitively consider injury size. However, the extent to which such measures (eg, hematoma size) improve risk prediction compared with the kids intracranial injury decision support tool for traumatic brain injury (KIIDS-TBI) model, which only includes the presence/absence of imaging findings, remains unknown.

Objective: To determine the extent to which measures of injury size improve risk prediction for children with mild traumatic brain injuries and ICIs. Read More

Turk Neurosurg 2021 Aug 13. Epub 2021 Aug 13.

Kameda Medical Center, Department of Spinal Surgery, Kamogawa-shi, Japan.

Aim: To analyze the clinical characteristics of thoracic ossified ligamentum flavum (OLF) and clarify prognostic factors.

Material And Methods: We retrospectively collected clinical data from the medical records of 29 patients who underwent decompressive surgery for myelopathy caused by thoracic OLF from 2011 to 2019. Associations between various clinical and radiological factors and surgical outcomes were analyzed. Read More

Asian J Surg 2022 06 4;45(6):1297-1298. Epub 2022 Mar 4.

Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung & Chang Gung University, Taiwan. Electronic address:

Acta Med Okayama 2022 Feb;76(1):71-78

Department of Orthopaedic Surgery, Okayama University Hospital.

The surgical treatment of pediatric atlantoaxial subluxation (AAS) in Down syndrome (DS) remains technically challenging due to radiation exposure and complications such as vertebral artery injury and nonunion. The established treatment is fixation with a C1 lateral mass screw and C2 pedicle screw (modified Goel technique). However, this technique requires fluoroscopy for C1 screw insertion. Read More

Animal Model Exp Med 2022 04 22;5(2):153-160. Epub 2022 Feb 22.

Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Background: A safe, effective, and ethically sound animal model is essential for preclinical research to investigate spinal medical devices. We report the initial failure of a porcine spinal survival model and a potential solution by fixating the spine.

Methods: Eleven female Dutch Landrace pigs underwent a spinal lumbar interlaminar decompression with durotomy and were randomized for implantation of a medical device or control group. Read More

Spine Surg Relat Res 2022 11;6(1):45-50. Epub 2021 Jun 11.

Department of Orthopaedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan.

Introduction: Due to the narrow portal of entry, microendoscopic laminectomy (MEL) is associated with a risk of postoperative spinal epidural hematoma (POSEH). This risk might be higher when performing multiple-level (m-) MEL. The purpose of this study is to clarify the incidence rate of POSEH following single-level (s-) and m-MEL by each interlaminar level and identify the risk factors for POSEH following m-MEL. Read More

Cureus 2022 Jan 18;14(1):e21390. Epub 2022 Jan 18.

Neurological Surgery, Norton Healthcare, Norton Neuroscience Institute, Louisville, USA.

Well-described complications of polyetheretherketone (PEEK) cranioplasty in pediatric patients include surgical site infection, post-operative hematoma, cerebral edema, and implant fracture. We present a rare case of hypersensitivity to PEEK presenting as an epidural effusion in a 7-year-old male receiving a PEEK cranioplasty following a decompressive craniectomy. Within three weeks, the patient experienced fever and emesis. Read More

JBJS Case Connect 2022 02 10;12(1). Epub 2022 Feb 10.

Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, Maryland.

Case: A 75-year-old woman with remote history of T10-S1 spinal fusion with pelvic fixation presented with radicular back pain and numbness in the right lower extremity. Imaging showed bilateral rod fractures at L4-5 and a dorsal spinal epidural hematoma (SEH) with associated severe canal narrowing and cauda equina compression. The patient underwent bilateral L4-5 laminectomies, hematoma evacuation, reinforcement of multilevel nonunion, and implant replacement. Read More

Acta Neurochir (Wien) 2022 06 6;164(6):1493-1499. Epub 2022 Feb 6.

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Background: To determine the optimal treatment for spontaneous spinal epidural hematoma (SSEH). The aim of this study was to identify factors associated with SSEH.

Methods: In 62 patients with SSEH, several patient-related parameters were analyzed as candidate factors associated with Frankel grade before treatment or at the last follow-up. Read More

Acta Neurochir (Wien) 2022 05 6;164(5):1229-1232. Epub 2022 Feb 6.

Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.

The use of antibiotics can, in rare cases, induce neuromuscular blockade (NMB), resulting in paralytic symptoms. Although such antibiotic-induced NMB has been described in the anaesthesiology and infectious disease literature, it is an unfamiliar clinical entity in the fields of neurosurgery and spinal surgery. Herein, we report a case of periodic quadriplegia due to NMB induced by perioperative prophylactic antibiotic of cefazolin, resulting in highly confusing paralytic symptoms during the acute postoperative phase of cervical laminoplasty, together with a review of the relevant literature. Read More