Hipertansif spinal epidural hematomun neden olduðu akut parapleji

Acute Paraplegia Caused by Hypertensive Spinal Epidural Haematoma

The hypertension is an uncommon cause in acute spinal epidural haematomas. The severe motor disability and need to emergency treatment to avoid the permanent neurological impairments underline its importance. Seventy-five year old male, admitted with acute paraplegia, numbness in the lower extremities and urinary incontinence for 4 hours. The neurological examination showed complete paraplegia, numbness from the below of thoracal 9 dermatomes, and loss of all sensory motor reflexes including anal reflexes. The blood pressure was 210/120 mm Hg on his admission. Thoracolomber magnetic resonance examinations detected an acute epidural haematoma, which was compressing to the cord. The patient underwent emergent laminectomy involving T 9 to L 2 and clots were removed with microsurgical technique. The patient was mobilized on the 3. and discharged from the hospital on the 7. postoperative day without neurological impairment. Although majority of the spontaneous spinal epidural haematomas is a recognized idiopathic condition, hypertension is much more commonly seen etiological factor than estimated. Early diagnosis, surgical decompression of the spinal cord and high dose corticosteroids might result in complete recovery.