A Spinal Epidural Hematoma is a condition that occurs when blood accumulates and compresses an area of the spinal cord and its nerve roots. The spine protects many important nerve functions that make up the spinal cord. The epidural space is made up of fat, spinal nerves, blood vessels, and connective tissue.
A hematoma is a collection of mostly clotted blood. So, when the space in an area of the spine is compressed or squeezed with a blood clot, it becomes a medical emergency that needs immediate medical attention. Too much pressure for any amount of time on the spinal cord can quickly lead to permanent nerve or brain damage if not addressed immediately.
Signs and symptoms of a spinal epidural hematoma indicate the need for medical attention within minutes to hours of onset, as the condition usually progresses rapidly. The following are some signs and symptoms of a spinal epidural hematoma:
A spinal epidural hematoma is caused when vessels in the spinal column area rupture. This rupture of internal vessels is usually caused by some type of haemorrhaging or bleeding from trauma or another underlying condition that may have caused sudden bleeding.
There are a number of physical conditions or procedures that may increase the risk of a spinal epidural hematoma to occur.
A spinal epidural hematoma is diagnosed through imaging. An MRI is recommended and currently the best diagnostic tool as it shows the most detailed imaging for this condition. If an MRI is unavailable, a CT scan is another type of imaging that can be done, usually in the form of a CT myelogram.
This kind of CT uses a contrast dye that is injected into the spinal area, which then gives an x-ray picture of the spinal canal. If CT scan results are negative, but the person is at high risk for a spinal epidural hematoma and has such symptoms, an MRI is recommended. This may indicate the need for a person to be transferred to a higher level of care where appropriate imaging and treatment are available.
The treatment for a spinal epidural hematoma is immediate surgery to decompress or relieve the pressure of the spinal cord. Surgery is urgent as it is important to drain the collection of blood compressing the spinal cord to limit neurological or brain damage. Because of the compression of the nerves, the hematoma itself and any surgical procedure may cause pain.
Managing pain and keeping the person as comfortable as possible is also important in the treatment process. Usually, certain medications, such as those that keep blood from clotting, will be discontinued to reduce the risk of more bleeding. Continuing to monitor brain function and movement of arms and legs will also be needed to assess for any potential damage that may have resulted from the spinal epidural hematoma.