Tzu-Chin Lin1, Zhuo-Hao Liu1, Amy L Bowes2, Shih-Tseng Lee1, Po-Hsun Tu3. 1. Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, Taiwan. 2. Royal Free London NHS Foundation Trust, London, United Kingdom. 3. Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, Taiwan. Electronic address: albert3343@gmail.com.
Abstract
BACKGROUND: Traumatic spinal epidural hematoma (TSEH) is a rare neurosurgical condition that according to conventional treatment requires prompt surgical decompression. Recent reports, however, suggest that conservative management within the acute phase after trauma also can lead to similar long-term functional outcomes without the need for immediate neurosurgical intervention. CASE DESCRIPTION: In the present paper, we describe 2 cases of TSEH located in the ventral upper cervical spine, which presented with delayed neurologic deficits. In both cases, conservative management with steroid treatment was initiated before neurosurgical decompression, resulting in improved neurologic outcomes. CONCLUSIONS: Urgent surgical decompression may not be necessary acutely in patients with TSEH who respond well to conservative therapy. Although there is currently no consensus for the initial management strategies, steroid treatment could individually tailored and applied according to the clinical condition and evolving symptoms.
BACKGROUND:Traumatic spinal epidural hematoma (TSEH) is a rare neurosurgical condition that according to conventional treatment requires prompt surgical decompression. Recent reports, however, suggest that conservative management within the acute phase after trauma also can lead to similar long-term functional outcomes without the need for immediate neurosurgical intervention. CASE DESCRIPTION: In the present paper, we describe 2 cases of TSEH located in the ventral upper cervical spine, which presented with delayed neurologic deficits. In both cases, conservative management with steroid treatment was initiated before neurosurgical decompression, resulting in improved neurologic outcomes. CONCLUSIONS: Urgent surgical decompression may not be necessary acutely in patients with TSEH who respond well to conservative therapy. Although there is currently no consensus for the initial management strategies, steroid treatment could individually tailored and applied according to the clinical condition and evolving symptoms.