• Journal of Trauma and Injury
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• v.23 no.2
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• pp.188-191
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• 2010

A postoperative contralateral supra- and infratentorial epidural hematoma after decompressive surgery is an extremely rare event. We describe a 38-year-old male with a contralateral supra- and infratentorial acute epidural hematoma just after decompressive surgery for an acute subdural hematoma. A contralateral skull fracture involving a lambdoidal suture and an intraoperative brain protrusion may be warning signs. The mechanisms, along with relevant literature, are discussed.

• Journal of Korean Neurosurgical Society
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• v.40 no.5
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• pp.384-386
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• 2006

Acute subdural hematoma is an exceptionally rare, but life-threatening complication of spinal anesthesia. The authors report here on a case of acute subdural hematoma in a 52-year-old male who underwent an arthroscopic knee joint operation under spinal epidural anesthesia due to tearing of the medial meniscus. He complained of headache after surgery. Computed tomography[CT] revealed acute subdural hematoma in the right fronto-tempo-parietal area. The headache progressed in spite of analgesics and bed rest; two weeks later, the CT showed subacute subdural hematoma with a mass effect. The patient improved after surgical decompression. The pathogenesis of subdural hematoma formation after dural puncture is discussed and we briefly review the relevant literature. Prolonged and severe postdural puncture headache[PDPH] should be viewed with suspicion and investigated promptly to rule out any intracranial complications. Immediate treatment of the PDPH with an epidural blood patch to prevent further CSF leakage should be considered.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.275-277
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• 2012

An eipdural hematoma in an infant is a very rare entity. We report a case of an acute traumatic intracranial epidural hematoma that developed with a lucid interval in a 4-month-old infant after a fall down from a bed. The infant was admitted at the emergency room. The child had initially cried and may have had a decreased level of consciouseness due to brain injury, but then returned to normal level of consciousness for several hours prior to admission. However, the infant had vomited twice after taking milk and then was lethargic. The brain CT revealed a lentiform-shaped huge hematoma on the right parietal area with a midline shift of 8 mm. An osteoplastic craniotomy was performed, and the intracranial epidural hematoma was totally removed. Postoperatively, the infant recovered well and was dischaged.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.131-135
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• 2000

Spontaneous spinal epidural hematoma, an idiopathic accumulation of blood in the vertebral epidural space without identifiable predisposing factors, is a rare condition. The diagnosis can be made from a careful history and neurological examination, but clinical diagnosis is often difficult because of its non-specific symptomatology and it can be confused with myocardial infarct, musculoskeletal pain, vasculitis and acute dissection of an aortic aneurysm. For a favourable outcome, early decompressive laminectomy and evacuation of hematoma are necessary. We report a 50-year-old female who presented with acute paraparesis and back pain on thoracic area. Diagnosis of spinal epidural hematoma which extended over $T_4-T_9$ was made by magnetic resonance imaging. We performed immediately decompressive laminectomy and evacuated the epidural hematoma. No cause for bleeding was evident. Postoperatively, neurological symptoms disappeared within six weeks.

• Journal of Korean Neurosurgical Society
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• v.58 no.5
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• pp.483-486
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• 2015

Cervical epidural steroid injection is frequently used in the conservative management of neck pain and cervical radiculopathy. Epidural cervical transforaminal injections are usually well-tolerated with mild side effects such as transient decreased sensory and motor function, or headache due to dural puncture. Although there are a few case reports about adverse effects of cervical epidural injection in the literature, it can cause severe complications such as large hematoma, infarction by spinal vascular injury. Subdural hematoma has been occurred much less common rather than epidural hematoma in the spinal cord. We report a rare catastrophic case of cervical spinal subdural hematoma with quadriparesis after cervical transforaminal epidural block.

• Journal of Korean Neurosurgical Society
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• v.40 no.1
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• pp.35-37
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• 2006

We present a case of acute spinal epidural hematoma[EDH] following unilateral laminectomy for bilateral decompression[ULBD]. A 45-year-old male presented with severe multi-level spinal stenosis underwent ULBD on the left side at the L2-3 and L3-4 level. Five hours after operation, paraparesis developed along with severe bilateral buttock pain. The CT scan showed an acute spinal EDH at the L2-3 level. The acute spinal EDH was successfully decompressed after emergency decompressive surgery with performing an additional laminectomy on the contralateral side at the L2-3 level. Although ULBD is an effective minimally invasive surgical technique for treating spinal stenosis, the possibility of acute spinal EDH should be kept in mind, as happened in our case.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.96-98
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• 2009

Acute epidural hematoma (AEDH) occurring as a result of traumatic head injury constitutes one of the most critical emergencies in neurosurgery. However, there are only several reports that show the rapid disappearance of AEDH without surgical intervention. We suggest redistribution of hematoma through the overlying skull fractures as the mechanism of rapid disappearance of AEDH. A 13-year-old female fell from a height of about 2 m and presented with mild headache. A computed tomography (CT) scan performed 4 hours after the injury revealed an AEDH with an overlying fracture in the right temporal region and acute small hemorrhagic contusion in the left frontal region. A repeat CT scan 16 hours after injury revealed that the AEDH had almost completely disappeared and showed an increase in the epicranial hematoma. The patient was discharged 10 days after injury with no neurological deficits. This case is characterized by the rapid disappearance of an AEDH associated with an overlying skull fracture. We believe that the rapid disappearance of the AEDH is due to the redistribution of the hematoma, rather than its resolution or absorption, and fracture plays a key role in this process.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.381-384
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• 2010

Spinal epidural hematoma (SEH) causing acute myelopathy is rare. The usual clinical presentation of a SEH is sudden severe neck or back pain that progresses toward paraparesis or quadriparesis, depending on the level of the lesion. Recent studies have shown that early decompressive surgery is very important for patient's recovery. We experienced five patients of cervico-thoracic epidural hematomas associated with neurologic deficits that were treated successfully with surgical intervention.

• Journal of Korean Neurosurgical Society
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• v.48 no.3
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• pp.281-284
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• 2010

Spinal epidural hematoma is a rare complication associated with pain control procedures such as facet block, acupuncture, epidural injection, etc. Although it is an uncommon cause of acute myelopathy, and it may require surgical evacuation. We report four patients with epidural hematoma developed after pain control procedures. Two procedures were facet joint blocks and the others were epidural blocks. Pain was the predominant initial symptom in these patients while two patients presented with post-procedural neurological deficits. Surgical evacuation of the hematoma was performed in two patients while in remaining two patients, surgery was initially recommended but not performed since symptoms were progressively improved. Three patients showed near complete recovery except for one patient who recovered with residual deficits. Although, spinal epidural hematoma is a rare condition, it can lead to serious complications like spinal cord compression. Therefore, it is important to be cautious while performing spinal pain control procedure to avoid such complications. Surgical treatment is an effective option to resolve the spinal epidural hematoma.

• Journal of Korean Neurosurgical Society
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• v.43 no.6
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• pp.304-306
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• 2008

Langerhans' cell histiocytosis (LCH) is a rare immunologic disorder characterized by histiocyte proliferation in multiple organ systems. Eosinophilic granuloma, a benign bone lesion, represents a focal form of LCH. We experienced a case of Langerhans' cell histiocytosis in a patient who presented with intracranial epidural hematoma and cyst on the midline of the frontal skull. A 10-year-old boy presented with a rapidly growing large scalp mass on the midline frontal area after mild head trauma. The scalp mass was painless and immobile. Plain skull x-ray showed a punched-out bone lesion. Computed tomography and magnetic resonance imaging showed a non-enhancing osteolytic lesion presenting with an epidural hematoma and cyst on the midline of the frontal skull. The lesion of the skull was completely resected and the patient's recovery was uneventful. The acute presentation of a solitary eosinophilic granuloma of skull with an epidural hematoma has been described in only five cases in the literature and we report the first case of LCH presenting as an intracranial epidural hematoma on frontal area.