Acta Neurochir (2014) 156:2155–2157 DOI 10.1007/s00701-014-2245-z
LETTER TO THE EDITOR - SPINE
Cyclic alternation of paraplegia and leg pain as symptoms of a giant spontaneous spinal epidural haematoma Bawarjan Schatlo & Pier-Paolo Panciani & Philippe Bijlenga & Karl Schaller
Received: 31 May 2014 / Accepted: 17 September 2014 / Published online: 27 September 2014 # Springer-Verlag Wien 2014
Dear Editor, Spontaneous spinal epidural haematoma (SSEH) is a neurosurgical emergency and can occur due to spinal arteriovenous malformations, haemangiomas or rupture of epidural venous plexus favoured by coagulation disorders. The initial symptoms include back pain with radicular or pseudoradicular irradiation which can progress to neurological signs of complete spinal cord compression [2, 6]. Prognostic factors for recovery after surgical decompression include preoperative neurological deficits, extent of affected vertebral segments, radiological signs of spinal cord compression and the interval between symptom onset and surgery [1, 3–5, 7]. We would like to bring your attention to a new set of fluctuating symptoms heralding the diagnosis of SSEH. A 60-year-old gentleman with a previous medical history of alcoholic liver disease and splenomegaly (thrombocytes at 64G/l, PT and aPTT within normal range) was transferred to our department after falling in the street at night. For the following 3 weeks he could not move his legs when waking up in the morning. It was only after sitting upright in his bed for about 5min that he regained control of his legs and was able to walk. However, in the course of the day he developed
B. Schatlo (*) Department of Neurosurgery, Georg-August University Göttingen, University Medicine Göttingen, Göttingen, Germany e-mail: [email protected] B. Schatlo e-mail: [email protected] P.
LETTER TO THE EDITOR - SPINE
Cyclic alternation of paraplegia and leg pain as symptoms of a giant spontaneous spinal epidural haematoma Bawarjan Schatlo & Pier-Paolo Panciani & Philippe Bijlenga & Karl Schaller
Received: 31 May 2014 / Accepted: 17 September 2014 / Published online: 27 September 2014 # Springer-Verlag Wien 2014
Dear Editor, Spontaneous spinal epidural haematoma (SSEH) is a neurosurgical emergency and can occur due to spinal arteriovenous malformations, haemangiomas or rupture of epidural venous plexus favoured by coagulation disorders. The initial symptoms include back pain with radicular or pseudoradicular irradiation which can progress to neurological signs of complete spinal cord compression [2, 6]. Prognostic factors for recovery after surgical decompression include preoperative neurological deficits, extent of affected vertebral segments, radiological signs of spinal cord compression and the interval between symptom onset and surgery [1, 3–5, 7]. We would like to bring your attention to a new set of fluctuating symptoms heralding the diagnosis of SSEH. A 60-year-old gentleman with a previous medical history of alcoholic liver disease and splenomegaly (thrombocytes at 64G/l, PT and aPTT within normal range) was transferred to our department after falling in the street at night. For the following 3 weeks he could not move his legs when waking up in the morning. It was only after sitting upright in his bed for about 5min that he regained control of his legs and was able to walk. However, in the course of the day he developed
B. Schatlo (*) Department of Neurosurgery, Georg-August University Göttingen, University Medicine Göttingen, Göttingen, Germany e-mail: [email protected] B. Schatlo e-mail: [email protected] P.
