Effective Steroid Treatment in Traumatic Cervical Spinal Epidural Hematoma Presenting with Delayed Tetraparesis: Two Case Reports and Literature Review.

Autor: Lin TC; Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, Taiwan., Liu ZH; Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, Taiwan., Bowes AL; Royal Free London NHS Foundation Trust, London, United Kingdom., Lee ST; Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, Taiwan., Tu PH; Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, Taiwan. Electronic address: albert3343@gmail.com.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2016 Jul; Vol. 91, pp. 673.e5-9. Date of Electronic Publication: 2016 Apr 20.
DOI: 10.1016/j.wneu.2016.04.040
Abstrakt: 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.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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