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Neurología (English Edition)
Article . 2010 . Peer-reviewed
License: Elsevier Non-Commercial
Data sources: Crossref
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Neurología (English Edition)
Article . 2010
License: Elsevier Non-Commercial
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
Neurología (English Edition)
Article . 2010
Data sources: DOAJ
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Spinal haematomas: The spinal aplopexy

Authors: M. Regueira Portas; P. Martínez Cueto; J. González García; E. Azevedo González; P. Varela Rois;

Spinal haematomas: The spinal aplopexy

Abstract

Introduction: Spinal haematomas (SH) are a rare pathology. They can produce a rapid and irreversible neurological deterioration. Patients and method: In this retrospective study, we review 8 of SH treated in our centre over the last five years. Data collected were: age, sex, predisposing factors, clinical status, radiological features, treatment and outcome. Results: Five patients were female and three male. Age ranged between 13 and 81 years. Five patients were hypertensive. Four had a coagulation disorder. In three patients SH occurred after physical effort. One case appeared after a lumbar puncture and another was secondary to intramedullary cavernous angioma. All patients presented with pain followed by neurological symptoms. Four cases were epidural, two subdural and two were intramedullary. All epidural SH and one subdural SH were located dorsal to medulla. Five patients were operated on due to progressive neurological deterioration. Only one of them showed neurological improvement. Patients who were not operated on had a better neurological status and they improved spontaneously. Two of them were discharged without neurological symptoms. Conclusions: There is controversy over physiopathology of SH. The triggering mechanisms are unknown. The vessel (artery or vein) and the anatomical compartment in which SH arise are also unknown. Prompt diagnosis and urgent surgical treatment are needed when the patient has neurological symptoms. In these cases, the most important prognostic factor is the preoperative neurological status. Resumen: Introducción: Los hematomas espinales (HE) son una afección muy poco frecuente, que puede causar un deterioro neurológico rápido e irreversible. Pacientes y método: Presentamos un estudio retrospectivo con 8 casos de HE tratados en nuestro servicio en los últimos 5 años. Se analizaron: edad, sexo, factores predisponentes, situación clínica, características radiológicas, tratamiento y evolución. Resultados: Los pacientes eran 5 mujeres y 3 varones. Las edades oscilaron entre 13 y 81 años. Cinco pacientes eran hipertensos; 4 presentaban alteraciones de la coagulación; en 3, el hematoma apareció en relación con un esfuerzo físico; en 1, tras una punción lumbar y en 1 fue secundario a un cavernoma intramedular. El inicio clínico fue en todos los casos con dolor, seguido de la instauración de síntomas neurológicos. Cuatro eran epidurales, dos subdurales y dos intramedulares. Todos los HE epidurales y uno subdural eran posteriores a la médula espinal. Cinco pacientes fueron intervenidos por deterioro neurológico progresivo. Sólo 1 presentó mejoría clínica. Los casos no intervenidos estaban en mejor situación neurológica y mejoraron espontáneamente, y 2 de ellos fueron dados de alta sin secuelas. Conclusiones: Los HE son procesos de fisiopatología controvertida. Se desconocen los mecanismos que los desencadenan, así como los vasos (arteriales o venosos) y el compartimento anatómico en que se originan. Se precisa un diagnóstico precoz y un tratamiento quirúrgico urgente cuando hay síntomas neurológicos progresivos. En estos casos, el factor pronóstico más importante es el estado neurológico preoperatorio. Keywords: Spinal aplopexy, Spinal epidural haematoma, Subaracnoid haematoma, Spinal subdural haematoma, Palabras clave: Apoplejía espinal, Hematoma epidural espinal, Hematoma subaracnoideo espinal, Hematoma subdural espinal

Keywords

Neurology. Diseases of the nervous system, RC346-429

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Average
Average
Average
gold