• World Neurosurg · Jul 2016

    Review Case Reports

    Effective Steroid Treatment in Traumatic Cervical Spinal Epidural Hematoma Presenting with Delayed Tetraparesis: two cases report and literature review.

    • Tzu-Chin Lin, Zhuo-Hao Liu, Amy L Bowes, Shih-Tseng Lee, and Po-Hsun Tu.
    • Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, Taiwan.
    • World Neurosurg. 2016 Jul 1; 91: 673.e5-9.

    BackgroundTraumatic spinal epidural hematoma (TSEH) is a rare neurosurgical condition that according to conventional treatment requires prompt surgical decompression. Recent reports, however, suggest that conservative management within the acute phase after trauma also can lead to similar long-term functional outcomes without the need for immediate neurosurgical intervention.Case DescriptionIn the present paper, we describe 2 cases of TSEH located in the ventral upper cervical spine, which presented with delayed neurologic deficits. In both cases, conservative management with steroid treatment was initiated before neurosurgical decompression, resulting in improved neurologic outcomes.ConclusionsUrgent surgical decompression may not be necessary acutely in patients with TSEH who respond well to conservative therapy. Although there is currently no consensus for the initial management strategies, steroid treatment could individually tailored and applied according to the clinical condition and evolving symptoms.Copyright © 2016 Elsevier Inc. All rights reserved.

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