Document Detail


Spontaneous epidural hematoma of thoracic spine presenting as Brown-Séquard syndrome: report of a case with review of the literature.
MedLine Citation:
PMID:  21903018     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spontaneous spinal epidural hematoma (SSEH) is an uncommon clinical entity. It produces a severe neurological deficit and prompt decompression is usually the first choice of treatment. Brown-Séquard syndrome is commonly seen in the setting of spinal trauma or an extramedullary spinal neoplasm, but rarely caused by SSEH.
METHODS: Case report and literature review.
FINDINGS: A previously healthy man presented with Brown-Séquard syndrome below T5-T6 cord segment secondary to spontaneous epidural hematoma. He opted for conservative treatment, which was followed by rapid resolution.
CONCLUSIONS: Although Brown-Séquard syndrome as a presenting feature of SSEH is rare, it does exist in exceptional case, which should be taken into consideration for differential diagnosis. Prompt surgical decompression is an absolute surgical indication widely accepted for patient with progressive neurological deficit. However, SSEH presenting with incomplete neurological insult such as Brown-Séquard syndrome might have a benign course. Successful non-operative management of this problem does not make it a standard of care, and surgical decompression remains the standard treatment for SSEH.
Authors:
Hong-Xin Cai; Chao Liu; Jian-Feng Zhang; Shuang-Lin Wan; Kenzo Uchida; Shun-Wu Fan
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The journal of spinal cord medicine     Volume:  34     ISSN:  1079-0268     ISO Abbreviation:  J Spinal Cord Med     Publication Date:  2011  
Date Detail:
Created Date:  2011-09-09     Completed Date:  2011-10-28     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  9504452     Medline TA:  J Spinal Cord Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  432-6     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics, Institute of Clinical Medicine of Zhejiang University, Hang Zhou, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Brown-Sequard Syndrome / physiopathology*
Hematoma, Epidural, Spinal / diagnosis*
Humans
Magnetic Resonance Imaging
Male
Spinal Cord / pathology*
Thoracic Vertebrae
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