Spontaneous spinal hematoma Experiences from a tertiary care centre in South India

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Rajeev Mandaka Parambil
Premkumar Sasi
Pavithran Vadakkam Muriyil
Byjo Valiyaveetil Jose
Akhil Mohan

Abstract

Background. Spontaneous spinal hematoma (SSH) is a rare condition that can result in severe functional disability and even death. But early detection and prompt intervention can substantially reduce the morbidity. We present a series of seven operated cases of SSH.


Methods. All operated cases of SSH between 2017 and 2019 were studied. The demographic and clinical features, risk factors and imaging features were analyzed. The functional outcome at discharge and 6 months were assessed.


Results. Seven operated cases of SSH with mean age 35(SD-20.9) were studied. Six cases were spontaneous spinal extradural hematomas (SSEDH) and one case was spontaneous spinal subdural hematoma (SSSDH). The most common site was cervicothoracic. Risk factors associated with SSH were thrombocytopenia, pregnancy, and necrotising pancreatitis. Two patients had preoperative Frankel’s grade A-B, three had grade C and two had D. The mean interval between the onset of symptoms and surgery was 4.7days.


The functional outcome was dependent on the pre-operative functional status of the patient. Patients with SSEDH and thrombocytopenia had a poor outcome.


Conclusion. SSH even though spontaneous may be associated with risk factors. The presence of thrombocytopenia and preoperative functional status predicted outcome. This is the only single institution case series to report thrombocytopenia as a factor predicting poor outcome.

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How to Cite
Mandaka Parambil, R., Sasi, P., Vadakkam Muriyil, P., Valiyaveetil Jose, B., & Mohan, A. (2020). Spontaneous spinal hematoma: Experiences from a tertiary care centre in South India . Romanian Neurosurgery, 34(4), 550–556. Retrieved from http://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/1600
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Author Biographies

Rajeev Mandaka Parambil

Professor and Head of Department. Department of Neurosurgery, Government Medical College. Kozhikode, Kerala, INDIA

Premkumar Sasi

Assistant Professor. Department of Neurosurgery, Government Medical College. Kozhikode, Kerala, INDIA

Pavithran Vadakkam Muriyil

Assistant Professor. Department of Neurosurgery, Government Medical College. Kozhikode, Kerala, INDIA

Byjo Valiyaveetil Jose

Assistant Professor. Department of Neurosurgery, Government Medical College. Kozhikode, Kerala, INDIA

Akhil Mohan

Senior Resident. Department of Neurosurgery, Government Medical College. Kozhikode, Kerala, INDIA