Diagnosis and Treatment of Spontaneous Thoracic Spinal Epidural Hematoma: A Case Report with Literature Review

Diagnosis and Treatment of Spontaneous Thoracic Spinal Epidural Hematoma: A Case Report with Literature Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Diagnosis and Treatment of Spontaneous Thoracic Spinal Epidural Hematoma: A Case Report with Literature Review Yinbin Wang, Lijun Cai, Mingyan Yang, Tianxiang Yang, Xueqi Liu, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7728365/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background and Objective: Spontaneous spinal epidural hematoma (SSEH) was first documented by Jackson in 1869, with an estimated incidence of 0.1 per 100,000 individuals. This condition progresses rapidly and may result in permanent neurological impairment. This study aims to investigate the clinical manifestations, diagnostic approaches, and therapeutic management of SSEH. Methods: A retrospective analysis was conducted on a patient diagnosed with SSEH and treated in the Department of Spinal Orthopedics at our hospital. Epidemiological data, clinical features, laboratory findings, imaging presentations, and treatment modalities were recorded. Therapeutic efficacy and prognostic outcomes were evaluated. Results: One week postoperatively, the patient exhibited significant improvement in lower extremity weakness and numbness. Conclusion: Early diagnosis and intervention are critical in the management of spontaneous spinal epidural hematoma to prevent delays in optimal treatment timing. Figures Figure 1 Figure 2 Figure 3 Introduction A retrospective analysis was conducted on a case of spontaneous spinal epidural hematoma (SSEH) treated in our hospital. Relevant literature was reviewed to explore the pathogenesis of the disease and provide some assistance for its diagnosis and treatment. Case Presentation A 72-year-old male was admitted to the Department of Neurology on September 17, 2020, due to "severe chest and back pain accompanied by numbness and weakness in both lower extremities for 12 hours". The patient reported that 12 hours ago, without any obvious trauma, he experienced severe chest and back pain, which gradually led to numbness and weakness in both lower extremities and incontinence. He was treated with hormones and neurotrophic drugs, and the pain was somewhat relieved. For further diagnosis and treatment, he was transferred to our department. The patient had a history of atrial fibrillation but had not received anticoagulant therapy. Physical examination upon admission revealed positive percussion and pressure pain in the thoracic and dorsal regions, no radiating pain in both lower extremities, muscle strength of 0 in both lower extremities, decreased pinprick sensation below the T8 level, absence of abdominal reflexes and bilateral patellar and Achilles tendon reflexes, and negative pathological signs. Thoracic MRI showed an extramedullary lesion at the T7-T9 vertebral levels, suggesting possible hematoma formation and spinal cord compression (Figure 1). The initial diagnosis was intraspinal lesion at the thoracic level with paraplegia and hematoma compression? On September 19, the patient underwent T6-T10 laminectomy, hematoma evacuation, and pedicle screw internal fixation under anesthesia. During the operation, a dark red hematoma about 1*2*4 cm was found in the posterior epidural space of the spinal canal (Figure 2). The hematoma was removed, and a negative pressure drainage was placed. Postoperatively, antibiotics were administered to prevent infection, and the patient was treated with oral mecobalamin and hormones. Seven days after the operation, the patient could stand and walk with the support of his family, and his bowel and bladder functions were normal. Physical examination showed muscle strength of grade 4 in both iliopsoas, quadriceps femoris, tibialis anterior, extensor hallucis longus, and gastrocnemius muscles, absence of bilateral patellar and Achilles tendon reflexes, presence of anal sphincter reflex, and negative pathological signs. Postoperative pathological examination revealed a large amount of coagulated blood (Figure 3). One-year follow-up showed that the patient had no recurrence of chest and back pain or symptoms in both lower extremities, and the muscle strength in both lower extremities had basically returned to normal. Discussion Spontaneous spinal epidural hematoma (SSEH) was first reported by Jackson in 1869, with an estimated incidence of approximately 0.1 per 100,000 individuals [1]. The condition progresses rapidly and may lead to permanent neurological impairment [2]. Current studies [3] define SSEH as the abnormal accumulation of blood within the spinal canal without significant trauma, resulting in symptoms of spinal cord compression. According to existing research [4], major risk factors include coagulation disorders and the use of anticoagulant medications; however, a substantial proportion of patients present with no identifiable risk factors [5,6]. From an anatomical perspective, the epidural venous plexus lacks venous valves, and developmentally anomalous vessels—due to structural and hemodynamic abnormalities—are prone to blood stasis. SSEH most commonly affects individuals between 40 and 50 years of age, with a male-to-female ratio of approximately 1.4:1 [7]. Clinical manifestations include sudden onset of cervicothoracic or back pain accompanied by radicular symptoms. Common neurological deficits comprise flaccid paralysis of the lower limbs, sensory disturbances, and diminished reflexes. Depending on the level and severity of spinal cord compression, clinical presentations vary; some patients may develop Brown-Séquard syndrome [8]. Magnetic resonance imaging (MRI) is currently regarded as the gold standard for diagnosing SSEH, as it clearly delineates the segmental location of the spinal lesion and the degree of cord compression. Based on MRI findings and the time since symptom onset [9], SSEH can be classified into hyperacute (14 days) stages, with signal characteristics varying according to the duration of hemorrhage. The severity of neurological impairment in Spontaneous Spinal Epidural Hematoma (SSEH) depends on the segmental extent of hematoma compression and the inflammatory response triggered by hematoma resorption [10]. Domestic scholars have reported that conservative treatments, such as corticosteroid administration and neurotrophic therapy, yield significant symptomatic improvement in patients with mild neurological impairment. This may be attributed to the dispersal of the hematoma through the epidural space and intervertebral foramina, leading to reduced intraspinal pressure and alleviated compression [11]. During conservative management, close monitoring of limb muscle strength and sensory changes is essential; surgical intervention should be promptly performed if symptoms worsen [12]. Hematoma evacuation and neural decompression within 48 hours of symptom onset typically result in favorable recovery outcomes for most patients [13]. Literature suggests that endoscopic hematoma evacuation offers enhanced operative precision, reduced soft tissue trauma, and decreased blood loss compared to conventional open surgery [14]. Some experts advocate surgical intervention within 36 hours for patients with complete neurological dysfunction, and within 48 hours for those with incomplete spinal cord injuries, to achieve optimal postoperative outcomes [15, 16]. In summary, SSEH is a rare clinical entity with an unclear etiology. Definitive diagnosis relies on clinical manifestations, physical signs, and MRI findings. Early surgical intervention with timely hematoma evacuation is crucial for promoting the recovery of spinal cord neurological function. Declarations Funding The author(s) declare that financial support was received for the research and/or publication of this article. This study was supported by the Key Scientific and Technological Achievements Transformation Project of Ningxia Hui Autonomous Region (2024CJE09046), the Open Project of Ningxia Clinical Medicine Research Institute, People’s Hospital of Ningxia Hui Autonomous Region (2023KFZD01), the Regional Program of National Natural Science Foundation of China (82060408), and the Innovation and Entrepreneurship Team Project for Overseas Returnees in Ningxia (NRS2021-5). Consent to participate We confirm that this study adhered to the Declaration of Helsinki and all methods were performed in accordance with the relevant guidelines and regulations. All patients and their families consented to the study. The patient and their families consented to the study’s publication. Ethics statement Written informed consent was obtained from the individual(s), and minor(s)’ legal guardian/next of kin, for the publication of any potentially identifiable images or data included in this article. Data availability statement The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding authors. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential con:ict of interest. References Bakker N A ,Veeger N J G M ,Vergeer R A ,et al. Prognosis after spinal cord and cauda compression in spontaneous spinal epidural hematomas[J]. Neurology, 2015, 84(18):1894-1903. Jackson, Robert. CASE OF SPINAL APOPLEXY.[J]. Lancet, 1869, 94(2392):5-6. Zhan Liu and Qingfang Jiao and Jianguo Xu and Xiang Wang and Sanzhong Li and Chao You. Spontaneous spinal epidural hematoma: analysis of 23 cases[J]. Surgical Neurology, 2008. Jessica, Figueroa, John G , et al. Spontaneous spinal epidural hematoma: literature review.[J]. Journal of spine surgery (Hong Kong), 2017. Bhat K J ,Kapoor S ,Watali Y Z ,et al. Spontaneous epidural hematoma of spine associated with clopidogrel: A case study and review of the literature[J]. asian j neurosurg, 2015, 10(1):54. Dziedzic T ,Kunert P ,Krych P ,et al. Management and neurological outcome of spontaneous spinal epidural hematoma[J]. Journal of Clinical Neuroscience, 2015. Figueroa J ,Devine J G .Spontaneous spinal epidural hematoma: literature review[J]. J Spine Surg, 2017, 3(1):58-63. Riaz S ,Jiang H ,Fox R , et al. Spontaneous Spinal Epidural Hematoma Causing Brown-Sequard Syndrome: Case Report and Review of the Literature[J]. Journal of Emergency Medicine, 2007, 33(3):241-244. Braun P ,Kazmi K , P Nogués-Meléndez, et al. MRI findings in spinal subdural and epidural hematomas[J]. European Journal of Radiology, 2007, 64(1):119-125. Wan Deyu. Clinical Research Progress of Spontaneous Epidural Hematoma within the Spinal Canal [J]. Chinese Journal of Spine and Spinal Cord,2012, 22(7):3. Bakker N A ,Veeger N ,Vergeer R A ,et al. Prognosis after spinal cord and cauda compression in spontaneous spinal epidural hematomas[J]. Neurology, 2015, 84(18):1894-1903. Oh J Y L ,Lingaraj K ,Rahmat R . Spontaneous spinal epidural haematoma associated with aspirin intake.[J]. Singapore Med J, 2008, 49(12):353-5. Spontaneous epidural hematoma of the spine associated with oral anticoagulants: 3 Case Studies[J]. International Journal of Surgery Case Reports, 2015, 13. Wu Z Y ,Zhu Y J ,Chu L , et al. Full-Endoscopic Transforaminal Approach for Removal of a Spontaneous Spinal Epidural Hematoma[J]. World Neurosurgery, 2017, 98:883.e13-883.e20. Hussenbocus S M ,Wilby M J ,Cain C ,et al. Spontaneous Spinal Epidural Hematoma: A Case Report and Literature Review[J]. Journal of Emergency Medicine, 2012, 42(2):e31-e34. Lan Tao, Chen Yang, Qian Wenbin, et al. A Case Report of Spontaneous Epidural Hematoma within the Cervical Spinal Canal [J]. Chinese Journal of Spine and Spinal Cord, 2014(5):478-480. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7728365","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":524311439,"identity":"a2002190-3212-4add-a6fd-1f0c7eb00c9a","order_by":0,"name":"Yinbin 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1","display":"","copyAsset":false,"role":"figure","size":89891,"visible":true,"origin":"","legend":"\u003cp\u003ePreoperative plain scan of thoracic vertebrae MRI\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7728365/v1/5c609a5c5910cc89c01bb778.jpg"},{"id":92977946,"identity":"2a46d8db-f4a8-4231-a6a7-7f59240f65d5","added_by":"auto","created_at":"2025-10-07 18:47:54","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":93363,"visible":true,"origin":"","legend":"\u003cp\u003eIntraoperative specimen images\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7728365/v1/fdfe3a20c5091bd017fb05c1.jpg"},{"id":92977810,"identity":"1955bc3c-c9ad-49eb-a880-12c0155786ac","added_by":"auto","created_at":"2025-10-07 18:39:54","extension":"jpg","order_by":3,"title":"Figure 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conducted on a case of spontaneous spinal epidural hematoma (SSEH) treated in our hospital. Relevant literature was reviewed to explore the pathogenesis of the disease and provide some assistance for its diagnosis and treatment.\u003c/p\u003e"},{"header":"Case Presentation","content":"\u003cp\u003eA 72-year-old male was admitted to the Department of Neurology on September 17, 2020, due to \u0026quot;severe chest and back pain accompanied by numbness and weakness in both lower extremities for 12 hours\u0026quot;. The patient reported that 12 hours ago, without any obvious trauma, he experienced severe chest and back pain, which gradually led to numbness and weakness in both lower extremities and incontinence. He was treated with hormones and neurotrophic drugs, and the pain was somewhat relieved. For further diagnosis and treatment, he was transferred to our department. The patient had a history of atrial fibrillation but had not received anticoagulant therapy. Physical examination upon admission revealed positive percussion and pressure pain in the thoracic and dorsal regions, no radiating pain in both lower extremities, muscle strength of 0 in both lower extremities, decreased pinprick sensation below the T8 level, absence of abdominal reflexes and bilateral patellar and Achilles tendon reflexes, and negative pathological signs. Thoracic MRI showed an extramedullary lesion at the T7-T9 vertebral levels, suggesting possible hematoma formation and spinal cord compression (Figure 1). The initial diagnosis was intraspinal lesion at the thoracic level with paraplegia and hematoma compression? On September 19, the patient underwent T6-T10 laminectomy, hematoma evacuation, and pedicle screw internal fixation under anesthesia. During the operation, a dark red hematoma about 1*2*4 cm was found in the posterior epidural space of the spinal canal (Figure 2). The hematoma was removed, and a negative pressure drainage was placed. Postoperatively, antibiotics were administered to prevent infection, and the patient was treated with oral mecobalamin and hormones. Seven days after the operation, the patient could stand and walk with the support of his family, and his bowel and bladder functions were normal. Physical examination showed muscle strength of grade 4 in both iliopsoas, quadriceps femoris, tibialis anterior, extensor hallucis longus, and gastrocnemius muscles, absence of bilateral patellar and Achilles tendon reflexes, presence of anal sphincter reflex, and negative pathological signs. Postoperative pathological examination revealed a large amount of coagulated blood (Figure 3). One-year follow-up showed that the patient had no recurrence of chest and back pain or symptoms in both lower extremities, and the muscle strength in both lower extremities had basically returned to normal.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eSpontaneous spinal epidural hematoma (SSEH) was first reported by Jackson in 1869, with an estimated incidence of approximately 0.1 per 100,000 individuals [1]. The condition progresses rapidly and may lead to permanent neurological impairment [2]. Current studies [3] define SSEH as the abnormal accumulation of blood within the spinal canal without significant trauma, resulting in symptoms of spinal cord compression. According to existing research [4], major risk factors include coagulation disorders and the use of anticoagulant medications; however, a substantial proportion of patients present with no identifiable risk factors [5,6]. From an anatomical perspective, the epidural venous plexus lacks venous valves, and developmentally anomalous vessels—due to structural and hemodynamic abnormalities—are prone to blood stasis. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSSEH most commonly affects individuals between 40 and 50 years of age, with a male-to-female ratio of approximately 1.4:1 [7]. Clinical manifestations include sudden onset of cervicothoracic or back pain accompanied by radicular symptoms. Common neurological deficits comprise flaccid paralysis of the lower limbs, sensory disturbances, and diminished reflexes. Depending on the level and severity of spinal cord compression, clinical presentations vary; some patients may develop Brown-Séquard syndrome [8]. Magnetic resonance imaging (MRI) is currently regarded as the gold standard for diagnosing SSEH, as it clearly delineates the segmental location of the spinal lesion and the degree of cord compression. Based on MRI findings and the time since symptom onset [9], SSEH can be classified into hyperacute (\u0026lt;24 hours), acute (1–3 days), subacute (3–7 days), and chronic (\u0026gt;14 days) stages, with signal characteristics varying according to the duration of hemorrhage.\u003c/p\u003e\n\u003cp\u003eThe severity of neurological impairment in Spontaneous Spinal Epidural Hematoma (SSEH) depends on the segmental extent of hematoma compression and the inflammatory response triggered by hematoma resorption [10]. Domestic scholars have reported that conservative treatments, such as corticosteroid administration and neurotrophic therapy, yield significant symptomatic improvement in patients with mild neurological impairment. This may be attributed to the dispersal of the hematoma through the epidural space and intervertebral foramina, leading to reduced intraspinal pressure and alleviated compression [11]. During conservative management, close monitoring of limb muscle strength and sensory changes is essential; surgical intervention should be promptly performed if symptoms worsen [12]. Hematoma evacuation and neural decompression within 48 hours of symptom onset typically result in favorable recovery outcomes for most patients [13]. Literature suggests that endoscopic hematoma evacuation offers enhanced operative precision, reduced soft tissue trauma, and decreased blood loss compared to conventional open surgery [14]. Some experts advocate surgical intervention within 36 hours for patients with complete neurological dysfunction, and within 48 hours for those with incomplete spinal cord injuries, to achieve optimal postoperative outcomes [15, 16]. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn summary, SSEH is a rare clinical entity with an unclear etiology. Definitive diagnosis relies on clinical manifestations, physical signs, and MRI findings. Early surgical intervention with timely hematoma evacuation is crucial for promoting the recovery of spinal cord neurological function.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eFunding\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe author(s) declare that financial support was received for the research and/or publication of this article. This study was supported by the Key Scientific and Technological Achievements Transformation Project of Ningxia Hui Autonomous Region (2024CJE09046), the Open Project of Ningxia Clinical Medicine Research Institute, People\u0026rsquo;s Hospital of Ningxia Hui Autonomous Region (2023KFZD01), the Regional Program of National Natural Science Foundation of China (82060408), and the Innovation and Entrepreneurship Team Project for Overseas Returnees in Ningxia (NRS2021-5).\u003c/p\u003e\n\u003cp\u003eConsent to participate\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe confirm that this study adhered to the Declaration of Helsinki and all methods were performed in accordance with the relevant guidelines and regulations. All patients and their families consented to the study. The patient and their families consented to the study\u0026rsquo;s publication.\u003c/p\u003e\n\u003cp\u003eEthics statement\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the individual(s), and minor(s)\u0026rsquo; legal guardian/next of kin, for the publication of any potentially identifiable images or data included in this article.\u003c/p\u003e\n\u003cp\u003eData availability statement\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding authors.\u003c/p\u003e\n\u003cp\u003eConflict of interest\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential con:ict of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBakker N A ,Veeger N J G M ,Vergeer R A ,et al. Prognosis after spinal cord and cauda compression in spontaneous spinal epidural hematomas[J]. Neurology, 2015, 84(18):1894-1903.\u003c/li\u003e\n\u003cli\u003eJackson, Robert. CASE OF SPINAL APOPLEXY.[J]. Lancet, 1869, 94(2392):5-6.\u003c/li\u003e\n\u003cli\u003eZhan Liu and Qingfang Jiao and Jianguo Xu and Xiang Wang and Sanzhong Li and Chao You. Spontaneous spinal epidural hematoma: analysis of 23 cases[J]. Surgical Neurology, 2008.\u003c/li\u003e\n\u003cli\u003eJessica, Figueroa, John G , et al. Spontaneous spinal epidural hematoma: literature review.[J]. Journal of spine surgery (Hong Kong), 2017.\u003c/li\u003e\n\u003cli\u003eBhat K J ,Kapoor S ,Watali Y Z ,et al. Spontaneous epidural hematoma of spine associated with clopidogrel: A case study and review of the literature[J]. asian j neurosurg, 2015, 10(1):54.\u003c/li\u003e\n\u003cli\u003eDziedzic T ,Kunert P ,Krych P ,et al. Management and neurological outcome of spontaneous spinal epidural hematoma[J]. Journal of Clinical Neuroscience, 2015.\u003c/li\u003e\n\u003cli\u003eFigueroa J ,Devine J G .Spontaneous spinal epidural hematoma: literature review[J]. J Spine Surg, 2017, 3(1):58-63.\u003c/li\u003e\n\u003cli\u003eRiaz S ,Jiang H ,Fox R , et al. Spontaneous Spinal Epidural Hematoma Causing Brown-Sequard Syndrome: Case Report and Review of the Literature[J]. Journal of Emergency Medicine, 2007, 33(3):241-244.\u003c/li\u003e\n\u003cli\u003eBraun P ,Kazmi K , P Nogu\u0026eacute;s-Mel\u0026eacute;ndez, et al. MRI findings in spinal subdural and epidural hematomas[J]. European Journal of Radiology, 2007, 64(1):119-125.\u003c/li\u003e\n\u003cli\u003eWan Deyu. Clinical Research Progress of Spontaneous Epidural Hematoma within the Spinal Canal [J]. Chinese Journal of Spine and Spinal Cord,2012, 22(7):3.\u003c/li\u003e\n\u003cli\u003eBakker N A ,Veeger N ,Vergeer R A ,et al. Prognosis after spinal cord and cauda compression in spontaneous spinal epidural hematomas[J]. Neurology, 2015, 84(18):1894-1903.\u003c/li\u003e\n\u003cli\u003eOh J Y L ,Lingaraj K ,Rahmat R . Spontaneous spinal epidural haematoma associated with aspirin intake.[J]. Singapore Med J, 2008, 49(12):353-5.\u003c/li\u003e\n\u003cli\u003eSpontaneous epidural hematoma of the spine associated with oral anticoagulants: 3 Case Studies[J]. International Journal of Surgery Case Reports, 2015, 13.\u003c/li\u003e\n\u003cli\u003eWu Z Y ,Zhu Y J ,Chu L , et al. Full-Endoscopic Transforaminal Approach for Removal of a Spontaneous Spinal Epidural Hematoma[J]. World Neurosurgery, 2017, 98:883.e13-883.e20.\u003c/li\u003e\n\u003cli\u003eHussenbocus S M ,Wilby M J ,Cain C ,et al. Spontaneous Spinal Epidural Hematoma: A Case Report and Literature Review[J]. Journal of Emergency Medicine, 2012, 42(2):e31-e34.\u003c/li\u003e\n\u003cli\u003eLan Tao, Chen Yang, Qian Wenbin, et al. A Case Report of Spontaneous Epidural Hematoma within the Cervical Spinal Canal [J]. Chinese Journal of Spine and Spinal Cord, 2014(5):478-480.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7728365/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7728365/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground and Objective: Spontaneous spinal epidural hematoma (SSEH) was first documented by Jackson in 1869, with an estimated incidence of 0.1 per 100,000 individuals. This condition progresses rapidly and may result in permanent neurological impairment. This study aims to investigate the clinical manifestations, diagnostic approaches, and therapeutic management of SSEH.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: A retrospective analysis was conducted on a patient diagnosed with SSEH and treated in the Department of Spinal Orthopedics at our hospital. Epidemiological data, clinical features, laboratory findings, imaging presentations, and treatment modalities were recorded. Therapeutic efficacy and prognostic outcomes were evaluated.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: One week postoperatively, the patient exhibited significant improvement in lower extremity weakness and numbness.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusion: Early diagnosis and intervention are critical in the management of spontaneous spinal epidural hematoma to prevent delays in optimal treatment timing.\u003c/p\u003e","manuscriptTitle":"Diagnosis and Treatment of Spontaneous Thoracic Spinal Epidural Hematoma: A Case Report with Literature Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-07 18:39:49","doi":"10.21203/rs.3.rs-7728365/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9fe7f7a6-cfc6-478f-9e73-d33f4c876d22","owner":[],"postedDate":"October 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-08T13:39:05+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-07 18:39:49","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7728365","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7728365","identity":"rs-7728365","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}