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J Neurosurg Spine 2019 Jan 11:1-9. Epub 2019 Jan 11.

OBJECTIVEMinimally invasive lumbar unilateral tubular laminotomy for bilateral decompression has gradually gained acceptance as a less destabilizing but efficacious and safe alternative to traditional open decompression techniques. The authors have further advanced the principles of minimally invasive surgery (MIS) by utilizing working-channel endoscope-based techniques. Full-endoscopic technique allows for high-resolution off-axis visualization of neural structures within the lateral recess, thereby minimizing the need for facet joint resection. Read More

World Neurosurg 2019 Jan 11. Epub 2019 Jan 11.

Department of Neurosurgery, Augusta University Medical Center, Augusta, Georgia, United States.

Object: Hemicraniectomy is a commonly performed neurosurgical procedure used in the setting of medically refractory malignant intracranial hypertension. Complications from cranioplasty following hemicraniectomy can be significant, including infection and wound issues. Difficulty with scar tissue during exposure for cranioplasty can be challenging and can lead to prolonged surgical time and increased bleeding. Read More

Surg Neurol Int 2018 13;9:254. Epub 2018 Dec 13.

Department of Neurosurgery, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 3021, Kansas City, KS, U.S.A.

Background: Spinal cord decompression after cervical spinal cord injury (SCI) is the standard of care. However, there is a lack of consensus regarding the optimal management of these injuries, including the role of traction and timing of surgery. Here, we report the safety/efficacy of ventral surgery without preoperative traction for intraoperative fracture reduction following acute cervical SCI. Read More

BMC Anesthesiol 2019 Jan 12;19(1):11. Epub 2019 Jan 12.

Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, China.

Background: Anticoagulant therapy during pregnancy is widely used due to the increasing awareness of maternal hypercoagulability. Few studies have reported the use of minimally invasive spinal anesthesia in these parturients. The objective of this study was to evaluate the safety and feasibility of minimally invasive spinal anesthesia in parturients with anticoagulation therapy undergoing cesarean section. Read More

Neurochirurgie 2019 Jan 8. Epub 2019 Jan 8.

Department of Orthopaedics, Shanghai Changzheng Hospital, Second Military Medical University, No. 415, Feng Yang Street, Huangpu District, Shanghai 200003, China.

Objective: To present the natural course and treatment modalities of spontaneous cervical epidural hematoma (SCEH), by reporting two rare cases with spontaneous resolution in both clinical and radiologic findings without surgery.

Material And Methods: One patient presenting with acute right side hemiparesis and another showing pure cervical radiculopathy were diagnosed with SCEH on magnetic resonance imaging (MRI). Both were both treated non-operatively. Read More

Rinsho Ketsueki 2018 ;59(12):2578-2582

Department of Medicine (Division of Hematology), Shiga University of Medical Science.

A 17-year-old woman was urgently transported to our hospital due to consciousness disturbance. A blood examination revealed intracerebral hemorrhage, WBC 233,800/l, blasts 93%, and disseminated intravascular coagulation. The results of bone-marrow aspiration indicated acute myeloid leukemia (M2 in FAB classification) with t (7;11) (p15;p15) and the resulting chimeric gene NUP98-HOXA9 and with FLT3-ITD. Read More

Case Rep Orthop 2018 27;2018:2860621. Epub 2018 Nov 27.

Spine Care Center, Wakayama Medical University Kihoku Hospital, Katsuragi-cho 649-7113, Japan.

Ligamentum flavum hematoma (LFH) is a rare cause of spinal nerve compression. This condition remains challenging to diagnose using MRI due to the changing intensity of the hematoma on imaging. The aim of this study was to describe the patient with LFH who had a succession of MRI scans carried out. Read More

World Neurosurg 2018 Dec 24. Epub 2018 Dec 24.

Department of Radiology, School of Medicine Udayana University, Sanglah General Hospital, Kasih Ibu General Hospital, Bali, Indonesia.

Background: Spinal subdural hematoma (SDH) concomitant with cranial SDH is extremely rare. The pathophysiology underlying this condition remains unclear. Some theories have been proposed. Read More

Anaesth Crit Care Pain Med 2018 Dec 23. Epub 2018 Dec 23.

Department of anaesthesiology and intensive care, Grenoble Alpes University Hospital, France. Electronic address:

Background: Patients on either antiplatelet or anticoagulant therapy may need procedures performed under peripheral nerve blocks in preference to general anaesthesia techniques. The risk of bleeding associated with peripheral nerve blocks under these circumstances remains unknown. This systematic review evaluates the incidence of bleeding complications following peripheral nerve blocks in patients receiving antiplatelet and/or anticoagulant medication. Read More

J Orthop Sci 2018 Dec 20. Epub 2018 Dec 20.

AUVA Trauma Center Salzburg, Academic Teaching Hospital of the Paracelsus Medical University, Salzburg, Austria. Electronic address:

Background: Although nonunions of the proximal humerus are rare, they cause significant disability to patients. Surgical reconstruction is challenging, especially with small and excavated head fragments. A promising surgical option is open reduction and stabilization using the Humerusblock device along with tension wires. Read More

J Obstet Gynaecol 2018 Dec 22:1-4. Epub 2018 Dec 22.

a Department of Gynaecology and Obstetrics , Kyoto University , Kyoto , Japan.

A caesarean section (CS) is a major risk factor for a venous thromboembolism, and enoxaparin, a low-molecular-weight heparin, has been widely used for thromboprophylaxis. However, it remains unclear whether an enoxaparin thromboprophylaxis has an acceptable safety profile when given early after CS compared to delayed administration, especially in the presence of an epidural catheter. This study aimed to survey cases in which enoxaparin administration was performed within 24 hours of CS and to evaluate patient outcomes with or without epidural anaesthesia. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Dec;32(12):1554-1559

Department of Spinal Surgery, Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an Shaanxi, 710054,

Objective: To explore the safety of ultrasonic osteotome used in posterior cervical laminectomy decompression surgery and its effect on surgical outcome.

Methods: A clinical data of 52 patients with ossification of posterior longitudinal ligament of cervical spine (C-OPLL) undergoing posterior cervical laminectomy decompression and fusion (PCLDF) between April 2013 and April 2017 was retrospectively analysed. The patients were divided into two groups according to whether using the ultrasonic osteotome during operation: group A (20 cases, ultrasonic osteotome group) and group B (32 cases, traditional gun-clamp decompression group). Read More

Int J Obstet Anesth 2018 Nov 29. Epub 2018 Nov 29.

Columbia University Medical Center, Department of Anesthesiology, New York, United States of America.

We report the case of a normotensive 31-year-old parturient who received combined spinal-epidural analgesia for early labor, and who was then found to have an unexpectedly low platelet count (25 000/μL) with elevated liver enzymes, but without alterations in blood pressure. Read More

Case Rep Obstet Gynecol 2018 7;2018:5879481. Epub 2018 Nov 7.

Department of Neurology, White Memorial Medical Center, Los Angeles, CA 90033, USA.

Background: Spontaneous epidural hematoma (SEH) is a rare finding in pregnancy, especially since most pregnant women do not have risk factors for developing SEH. The presence of epidural anesthesia can delay the diagnosis of SEH in pregnant patients. Immediate surgical decompression is the current standard of care for treating SEH. Read More

Neurospine 2018 Dec 7;15(4):338-347. Epub 2018 Oct 7.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Objective: Patients with extradural spine tumors are at an increased risk for intraoperative cerebrospinal fluid (CSF) leaks and postoperative wound dehiscence due to radiotherapy and other comorbidities related to systemic cancer treatment. In this case series, we discuss our experience with the management of intraoperative durotomies and wound closure strategies for this complex surgical patient population.

Methods: We reviewed our recent single-center experience with spine surgery for primarily extradural tumors, with attention to intraoperative durotomy occurrence and postoperative wound-related complications. Read More

World Neurosurg 2018 Dec 3. Epub 2018 Dec 3.

Department of Neurological Surgery, Policlinico "G. Rodolico" University Hospital, Via Santa Sofia 86, 95123 - Catania, Italy.

Background: Arachnoiditis ossificans (AO) is a rare condition often associated with previous spine surgery. Here we describe a unique case of a patient affected by ankylosing spondylitis (AS), presenting with progressive neurological deterioration due to AO. We also review the literature on evaluation and management of patients suffering from AO. Read More

World Neurosurg 2018 Nov 27. Epub 2018 Nov 27.

Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.

Objective: To retrospectively analyze the outcomes and complications of patients with metastatic thoracic spinal tumors (MTTs) who underwent posterior corpectomies.

Methods: Ninety patients with MTTs who underwent posterior corpectomies were retrospectively analyzed. Characteristics evaluated included number of MTTs per year, location, involved vertebrae numbers, sex, histology, pre- and postoperative American Spinal Injury Association (ASIA) grade, visual analog scale (VAS) pain scores, operative time, blood loss, and length of hospital stay. Read More

World Neurosurg 2018 Nov 27. Epub 2018 Nov 27.

Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA. Electronic address:

Background: In the modern, increasingly pay-for-performance era, unplanned return to the operating room (ROR) is gaining attention as a surgical quality metric. However, large-scale data on the appropriateness and usefulness of this measure in neurosurgery are scarce.

Objective: To provide a comprehensive description of all RORs after neurosurgical procedures in a national surgical registry and identify factors associated with ROR. Read More

Surg Neurol Int 2018 23;9:213. Epub 2018 Oct 23.

Department of Neurosurgery, Riverside University Health System, Riverside, California, USA.

Background: Brown-Sequard syndrome (BSS) is a well-known entity that is most commonly caused by a penetrating injury to the spinal cord (e.g., stab wound or gunshot wound). Read More

World Neurosurg 2018 Nov 23. Epub 2018 Nov 23.

Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.

Background: In patients with ankylosing spinal disease, including ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis, even low-impact trauma can lead to complex injuries. The injuries seem to be highly unstable and associated with greater mortality rates compared with the general spine trauma population.

Methods: We reviewed the medical records of a consecutive series of 41 patients (34 men, 7 women) with ankylosing spinal disease and unstable traumatic spine injuries who were admitted to our department from 2007 to 2016. Read More

Cureus 2018 Sep 22;10(9):e3347. Epub 2018 Sep 22.

Neurological Surgery, Haider Spine Center, Riverside, USA.

Anti-coagulation medications are widely used in clinical practice, especially in the United States as cardiac-related emergencies are on the rise. An overarching caveat in using anti-coagulation drugs as a long-term treatment regimen, such as warfarin, is that patients are closely monitored by their primary care provider. Routine monthly laboratory examinations are strictly required to assess the international normalized ratio (INR) which measures prothrombin time (PT), providing insight into how long it takes for blood to clot. Read More

Brain Dev 2018 Nov 21. Epub 2018 Nov 21.

Department of Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.

Background: The initial symptoms of Guillain-Barre Syndrome (GBS) can be similar to a case of spontaneous spinal epidural hematoma (SSEH) located at the cervicothoracic junction. Therefore, SSEH may be misdiagnosed as GBS.

Case Report: A previously healthy 6-year-old girl presented with a 2-day history of progressive pain in the lower extremities and an inability to walk. Read More

Radiographics 2019 Jan-Feb;39(1):213-228. Epub 2018 Nov 23.

From the Department of Radiological Sciences, University of Oklahoma Health Sciences Center, PO Box 26901, Garrison Tower, Suite 4G4250, Oklahoma City, OK 73126 (D.G., B.O.C., S.J., A.M.A.); and Department of Radiology, Stanford University School of Medicine, Palo Alto, Calif (H.M.D.).

Infants and children under 2 years of age are at greatest risk for devastating neurologic complications following nonaccidental trauma. While a subdural hematoma (SDH) is the most common finding and is often enough to raise suspicion for abuse, no single injury is pathognomonic for abusive head trauma (AHT). Rather, the combination of imaging and physical findings and the clinical presentation help confirm the diagnosis of AHT. Read More

Asian J Neurosurg 2018 Oct-Dec;13(4):1282-1284

Department of Neurosurgery, University Hospital Center Zagreb, University of Zagreb, School of Medicine, Zagreb, Croatia.

Spinal cord lipomas are rare and benign tumors which may cause progressive neurological deficits due to their local expansion. We present the case of a 59-year-old male patient with severe lumbosacral pain and slowly progressive paresis of the right leg, misdiagnosed with degenerative spine disease. Repeated magnetic resonance (MR) T1-weighted images of the thoracic spine suggested a subacute intramedullary hematoma. Read More

Soud Lek 2018 ;63(3):25-28

Spinal subdural hematoma is a rare and potentionally life-threatening condition associated with trauma and other pathological conditions. In this paper we report the autopsy findings of a 64 year old male who was repeatedly hospitalized with traumatic head injuries in the past. In this case spinal subdural hematoma was diagnosed post-mortem and later comfirmed by ante-mortem CT scan revaluation. Read More

Br J Radiol 2018 Nov 27:20180532. Epub 2018 Nov 27.

1 Department of Radiology, Mater Misericordiae University Hospital , Dublin , Ireland.

Spinal haematoma is a rare occurrence, however has the potential to cause significant spinal injury and morbidity. MRI is the gold-standard of investigation, and urgent imaging is required for early diagnosis and treatment to ensure best patient outcomes. We present a pictorial review demonstrating the imaging features of spinal haematoma based on meningeal space assignment; epidural, subdural, subarachnoid, intramedullary and a combination of these locations. Read More

Medicine (Baltimore) 2018 Nov;97(45):e13090

Department of Physical Medicine and Rehabilitation, Spine Center, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.

Rationale: Epidural hematoma is a possible complication after neuraxial procedures. Recently, caudal epidural pulsed radiofrequency (PRF) stimulation was reported as an effective method for controlling several types of chronic pain. Herein, we report on a patient who developed a lumbar epidural hematoma after receiving caudal epidural PRF stimulation. Read More

World Neurosurg 2018 Nov 4. Epub 2018 Nov 4.

Department of Neurosurgery, Institute of Neurosciences, Medanta The Medicity, Sector 38 Gurgaon, Haryana, India-122001.

Background: Neurological complications are increasingly being reported in dengue epidemics. Intra-spinal hematomas are rare and those associated with dengue fever are still rarer with only one being reported in literature.

Case Description: We report a case of dengue fever presenting with acute onset quadriparesis (upper limbs MRC 4/5 and lower limbs 0/5) and urinary incontinence. Read More

J Clin Neurosci 2019 Jan 2;59:270-275. Epub 2018 Nov 2.

The University of Tokyo Hospital, Japan.

Spontaneous spinal epidural hematoma (SSEH) in the cervical spine is rare, and it remains unclear how this condition resolves. We aimed to elucidate the underlying pathology of SSEH conservatively treated using magnetic resonance imaging (MRI) analysis. We reviewed the clinical records of patients with SSEH treated conservatively between January 2011 and November 2016 and analyzed the patients' medical history, medication, spinal cord compression on MRI, and neurological status. Read More

BMC Complement Altern Med 2018 Oct 29;18(1):291. Epub 2018 Oct 29.

Department of Orthopaedics, Hanil General Hospital, 308 Uicheon-ro, Dobong-Gu, Seoul, 132-703, South Korea.

Background: Spontaneous spinal epidural hematoma (SSEH) is an uncommon disease, but it can lead to acute cord compression with disabling consequences. Identifiable reasons for spontaneous hemorrhage are vascular malformations and bleeding disorders. However, SSEH after taking herbal medicines has not been described yet. Read More

Indian J Urol 2018 Oct-Dec;34(4):283-286

Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Introduction: We aim to present a modified technique and outcomes of a novel method allowing for direct visualization of the reservoir placement during a penoscrotal inflatable penile prosthesis (IPP).

Methods: Out of165 patients who underwent IPP placement from August 2012 to March 2015, 157 underwent a modified technique and comprised the cohort of this study. A Deaver's retractor was placed lateral to the penis and over the pubic bone to allow for direct visualization of the tissues overlying the lower abdomen. Read More

World Neurosurg 2018 Oct 16. Epub 2018 Oct 16.

Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Objective: Spontaneous spinal epidural hematoma (SSEH) is a rare and morbid entity, with the prognosis affected by delayed diagnosis and surgical intervention. The correlation between the timing of the intervention and neurological recovery has not been clearly reported. We present a retrospective study of SSEH to determine the correlation between the timing of surgical intervention and changes in the spinal cord signal on magnetic resonance imaging (MRI) with the neurological outcome. Read More

NMC Case Rep J 2018 Oct 13;5(4):105-109. Epub 2018 Sep 13.

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

Concurrent multiple tumors developing in the spinal cord are rare, except for in genetic disorders, such as neurofibromatosis and von Hippel-Lindau disease. Furthermore, concurrent tumors arising in the same spinal level with discrete histopathology are much rarer. We report two such cases. Read More

J Clin Neurosci 2018 Dec 13;58:210-212. Epub 2018 Oct 13.

University of California San Francisco, Department of Neurological Surgery, San Francisco, CA, USA. Electronic address:

Background And Importance: Advances in minimally invasive (MIS) and mini-open surgical approaches have led to reductions in perioperative morbidity without compromising rates of resection of non-degenerative intradural spinal pathologies. Whether these approaches may be adapted for the surgical resection for intramedullary vascular malformations - such as cavernous malformations (CMs) - has yet to be reported. The authors describe a mini-open transspinous approach to resect a ruptured intramedullary CM of the conus medullaris. Read More

World Neurosurg 2019 Jan 13;121:e954-e961. Epub 2018 Oct 13.

Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Objective: We studied the postoperative morphology of the dura mater and analyzed the probability of epidural hematoma (EH) after anterior controllable antedisplacement and fusion (ACAF).

Methods: A total of 63 patients with a diagnosis of ossification of the posterior longitudinal ligament (OPLL) and degenerative kyphosis and stenosis (DKS) had undergone ACAF from 2016 to 2017. All these patients had undergone cervical plain films, computed tomography, and magnetic resonance imaging (MRI). Read More

Neural Regen Res 2018 Dec;13(12):2200-2208

Translational Medicine Center, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.

Flavonoids from Huangqin (dried roots of Scutellaria baicalensis Georgi) have anti-inflammatory effects, and are considered useful for treatment of spinal cord injury. To verify this hypothesis, the T9-10 spinal cord segments of rats were damaged using Allen's method to establish a rat spinal cord injury model. Before model establishment, Huangqin flavonoid extraction (12. Read More

Eur Spine J 2018 Oct 9. Epub 2018 Oct 9.

Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan.

Purpose: Potential associations between radiographic parameters and the incidence of symptomatic postoperative spinal epidural hematoma (PSEH) have not been identified. This study aimed to identify risk factors including radiographic parameters for symptomatic PSEH after posterior decompression surgery for lumbar spinal canal stenosis (LSS).

Methods: We retrospectively reviewed 1007 consecutive patients who underwent lumbar decompression surgery for lumbar spinal canal stenosis (LSS) at our institution. Read More

Neurosurgery 2018 Oct 8. Epub 2018 Oct 8.

Surgical Outcomes Program, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.

Background: Return to the operating room (ROR) has been put forth by the National Quality Forum and the American College of Surgeons as a surgical quality indicator. However, current quality metrics fail to consider the nature and etiology of the ROR.

Objective: To provide a comprehensive description of all reoperations after neurosurgical procedures and assess the validity of ROR as a quality measure in neurosurgery. Read More

Surg Neurol Int 2018 21;9:195. Epub 2018 Sep 21.

Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Background: Current management of acute spinal cord infarction (SCI) is limited. Lumbar cerebrospinal fluid drainage (CSFD) with blood pressure augmentation is utilized in the thoracic/thoracoabdominal aortic repair and thoracic endovascular aortic repair (TEVAR) populations to increase spinal perfusion pressure.

Case Description: We identified 3 patients who sustained acute SCI and underwent CSFD and maintenance of elevated mean arterial pressure (MAP) within 24 hours of injury. Read More

World Neurosurg 2019 Jan 5;121:e700-e711. Epub 2018 Oct 5.

Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan.

Objective: The diagnosis and treatment of intracranial hypotension associated with a spinal cerebrospinal fluid (CSF) leak, especially in comatose patients, have yet to be established.

Methods: Clinical manifestations, neuroimaging findings, and treatment outcomes in 11 patients (Glasgow Coma Scale score 10 ± 4) were described and compared with 36 patients with normal consciousness.

Results: Patients with disturbed consciousness were diagnosed at a significantly older age (55 ± 11 years; P < 0. Read More

Am J Med 2018 Oct 3. Epub 2018 Oct 3.

Division of Spine Surgery, Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, RI.

Atraumatic spinal emergencies often present a diagnostic and management dilemma for health care practitioners. Spinal epidural abscess, cauda equina syndrome, and spinal epidural hematoma are conditions that can insidiously present to outpatient medical offices, urgent care centers, and emergency departments. Unless a high level of clinical suspicion is maintained, these clinical entities may be initially misdiagnosed and mismanaged. Read More

Asian J Neurosurg 2018 Jul-Sep;13(3):870-872

Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan.

A case of delayed occurrence of C3 vertebra anterior subluxation diagnosed 10 days after surgery for epidural hematoma is herein described. A 56-year-old man underwent surgery for right epidural hematoma. No spinal fracture was identified on the cervical-spinal computed tomography (CT) on arrival. Read More

Int J Spine Surg 2018 Jan 30;12(1):26-29. Epub 2018 Mar 30.

Department of Neurosurgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Spontaneous cervical epidural hematoma is an uncommon cause of acute spinal cord compression. This is a rare idiopathic condition that leads to acute onset of neurologic deficits, which if not recognized early can have catastrophic consequences. Acute cervical epidural hematoma is definitely a condition of neurologic emergency. Read More

Int J Spine Surg 2018 Jun 15;12(3):337-341. Epub 2018 Aug 15.

Department of Neurosurgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

A 61-year-old woman with no past medical history presented with low back pain and radicular pain in the right lower extremity. Magnetic resonance imaging of the lumbar spine showed a heterogeneous intensity mass in the lateral recess of the spinal canal at the L4-5 disk level. Postoperatively, her radicular pain resolved within a few days with excellent low back pain relief. Read More

Spinal Cord Ser Cases 2018 21;4:87. Epub 2018 Sep 21.

Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong China.

Introduction: Vertebroplasty (VP) is a well-known and effective therapeutic method for relieving the pain and improving the quality of life of patients with vertebral compression fractures. Major complications of VP are infrequent, occurring in no more than 1% of such procedures, whereas spinal subdural and epidural hematomas are extremely rare complications.

Case Presentation: We present a unique case of a spinal subdural hematoma (sSDH) (from T4 to T12) occurring immediately after VP to treat a traumatic vertebral compression fracture, followed by a spinal epidural hematoma (SEH) (from T3 to T12) after the decompressive laminectomy, occurring in a 64-year-old patient. Read More

Ochsner J 2018 ;18(3):268-270

University of Miami, School of Medicine, Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Health System, Jackson Memorial Hospital, Miami, FL.

Background: Spinal epidural hematomas (SEHs) are a rare but serious complication associated with spinal surgery, with an incidence estimated to be as high as 3%. Patients present with back pain and neurologic symptoms, with a typical onset time of several hours to days following surgery.

Case Report: A 60-year-old female who underwent cervical spine surgery had negative intraoperative neuromonitoring and no apparent neurologic deficits of the upper extremities immediately postsurgery. Read More

World Neurosurg 2018 Dec 26;120:500-505. Epub 2018 Sep 26.

Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Republic of Korea.

Background: Kummell disease is defined as avascular necrosis of vertebra, occurs after the delayed posttraumatic osteoporotic vertebral collapse, and mainly occurs in adults older than 50 years of age. We report the first case of refracture of Kummell disease and epidural hematoma followed by paraparesis.

Case Description: A 67-year-old woman with a known case of osteoporotic T12 fracture (3 months back) visited our outpatient clinic complaining of persistent back pain and paraparesis after jerking while getting up from the bed. Read More

Medicine (Baltimore) 2018 Sep;97(38):e12479

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan.

Rationale: A spinal subdural hematoma (SDH) is rarely complicated with an intracranial SDH. We found only 7 cases of spontaneous concurrent lumbar spinal and cranial SDHs, in which lumbar symptoms occurred before head symptoms.

Patient Concerns: We describe a 77-year-old man with spontaneous concurrent spinal and cranial SDHs, in whom the spinal SDH was identified 30 days before the intracranial chronic SDH. Read More

Am J Case Rep 2018 Sep 17;19:1103-1107. Epub 2018 Sep 17.

Department of Neurology, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon.

BACKGROUND A lumbar puncture is a procedure performed to uncover the state of the central nervous system by analysis of the cerebrospinal fluid. It is done also to infuse medications in the subdural space. A lumbar puncture should not cause central nervous system bleeding, but this complication is still occurring in certain cases. Read More

Radiographics 2018 Sep-Oct;38(5):1516-1535

From the Departments of Radiology and Medical Imaging (J.L.P., J.H.D., N.C.N., C.R.Q., M.T.P., N.F., M.D.M., C.A.S.) and Orthopedic Surgery (G.A.F., F.H.S.), University of Virginia, 1215 Lee St, Charlottesville, VA 22908.

Spinal hematomas are a frequent indication for radiologic evaluation and can be a diagnostic dilemma for many radiologists and surgeons. There are four types of spinal hematomas: epidural, subdural, subarachnoid, and intramedullary (spinal cord) hematomas. Because they differ by their location in relationship to the meningeal membranes and spinal cord, unique radiologic appearances can be recognized to distinguish these types of spinal hemorrhage. Read More