• Journal of Korean Neurosurgical Society
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• 제39권1호
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• pp.61-63
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• 2006

We report a unique case of a neonate with an epidural hematoma induced by vacuum extraction. The epidural hematoma, communicating with a cephalhematoma through a linear skull fracture, disappeared after ultrasound-guided needle aspiration. The patient quickly recovered and one month later computed tomography revealed a complete resolution of the epidural hematoma.

• Journal of Korean Neurosurgical Society
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• 제58권5호
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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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• 제48권3호
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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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• 제49권4호
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• pp.231-233
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• 2011

Chronic spinal epidural hematoma related to Kummell's disease is extremely rare. An 82-year-old woman who had been managed conservatively for seven weeks with the diagnosis of a multi-level osteoporotic compression fracture was transferred to our institute. Lumbar spine magnetic resonance images revealed vertebral body collapse with the formation of a cavitary lesion at L1, and a chronic spinal epidural hematoma extending from L1 to L3. Because of intractable back pain, a percutaneous vertebroplasty was performed. The pain improved dramatically and follow-up magnetic resonance imaging obtained three days after the procedure showed a nearly complete resolution of the hematoma. Here, we present the rare case of a chronic spinal epidural hematoma associated with Kummell's disease and discuss the possible mechanism.

• Journal of Korean Neurosurgical Society
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• 제30권7호
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• pp.943-946
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• 2001

We report a case of 15 year-old female patient with a ossified chronic epidural hematoma. She had had head trauma 10 weeks previously and conservative care for delayed onset epidural hematoma at other hospital. Ossification was identified about 4 weeks after head injury and then progressed rapidly. We removed the chronic epidural hematoma with thick capsule and newly formed bone. The mechanism of the ossification associated with cephalhematoma and chronic subdural hematoma is reviewed and discussed.

• Journal of Korean Neurosurgical Society
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• 제44권1호
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• pp.40-42
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• 2008

Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but significant spinal condition. Urgent surgical evacuation of a hematoma is generally indicated to prevent serious permanent neurological deficits. We encountered three cases of spontaneous spinal epidural hematomas associated with motor weakness that were treated successfully by surgical intervention.

• Journal of Trauma and Injury
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• 제23권2호
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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.

• The Korean Journal of Pain
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• 제9권1호
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• pp.271-274
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• 1996

Epidural hematoma during anticoagulant therapy is a rare complication of central neural blockade, but it may result in serious neurologic sequelae. A 61-year-old male receiving warfarin due to heart failure was referred to the pain clinic for control of severe herpetic neuralgia. Epidural catheterization was done at $T_{8-9}$ interspace. At that time, PT and aPTT were extremely prolonged. The next morning, severe back pain, motor paralysis and urinary difficulty developed. On spine MRI, epidural hematoma was detected at $T_{8-9}$ interspace. Four days later, he died due to underlying diseases. Central neural blockade in patient with anticoagulant therapy is contraindicated in most cases. If is undertaken, close observation of patients's neurologic functions and monitoring of coagulation profiles(PT, aPTT, etc) are necessary. If epidural hematoma develops, early surgical decompression is mandatory.

• Journal of Korean Neurosurgical Society
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• 제43권6호
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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.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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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.