Subdural hematoma or a spinal epidural is an accumulation of blood in the subdural or epidural space, which may mechanically compress the spinal cord. The diagnosis is made by an MRI or, if not available immediately, through a CT myelography. Treatment is with immediate surgical drainage.

(See also overview of diseases of the spinal cord.)

Subdural hematoma or a spinal epidural is an accumulation of blood in the subdural or epidural space, which may mechanically compress the spinal cord. The diagnosis is made by an MRI or, if not available immediately, through a CT myelography. Treatment is with immediate surgical drainage. (See also overview of diseases of the spinal cord.) Spinal subdural or epidural hematoma (usually thoracic or lumbar) are rare, but they can result of a spinal trauma, Antikoagulanzien- or thrombolytic therapy or be in patients with increased bleeding tendency, a result of a spinal tap. Symptoms and signs The symptoms of spinal subdural hematoma or epidural start with local or radicular back pain and tenderness on percussion; they are often heavily marked. Spinal cord compression can form. The compression of lumbar spinal roots can cause a cauda equina syndrome and paralysis of the lower limbs. The deficits develop over minutes to hours. Diagnosis MRI A hematoma may be considered for patients with acute non-traumatic spinal cord compression or sudden, unexplained paralysis of the lower limbs into consideration v. a. if a possible cause (z. B. trauma, blood coagulation disorders) exists. The diagnosis is made by an MRI or when an MRI is available immediately through a CT myelography. Drainage treatment The treatment of a spinal or epidural subdural hematoma exists in the immediate surgical drainage. Patients taking anticoagulants kumarinhaltige receive phytomenadion (vitamin K1) 2.5-10 mg s.c. and as required fresh frozen plasma to normalize the INR. Patients with thrombocytopenia receive platelet concentrates.

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