Artikel
Functional outcome after microsurgical treatment of spontaneous and non-spontaneous spinal subdural hematomas
Funktionelles Outcome nach mikrochirurgischer Behandlung spontaner und nicht-spontaner spinaler Subduralhämatome
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Autoren
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R. Thiex
- Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
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A. Thron
- Abteilung für Neuroradiologie, Universitätsklinikum der RWTH Aachen
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J.M. Gilsbach
- Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
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V. Rohde
- Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
| Veröffentlicht: | 8. Mai 2006 |
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Gliederung
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Objective: Due to the rarity of spinal subdural hematomas, literature offers scarce estimates of the outcome and predictive factors in patients suffering from a spinal subdural hematoma. In addition, one-institutional microsurgical series are still lacking. Therefore, we retrospectively evaluated the early and long-term functional outcome of eight patients with spontaneous and non-spontaneous spinal subdural hematomas who underwent microsurgical evacuation of the clot.
Methods: The charts of eight patients with spinal subdural hematoma were evaluated for etiology, risk factors, neurological deficits at symptom onset and 28 days after surgical removal of the spinal subdural hematoma. Long-term clinical outcome (Barthel-Index) was evaluated by a telephone questionnaire with the patient or relative.
Results: Only one patient with spontaneous spinal subdural hematoma was identified. Four patients were on anticoagulant therapy, three patients had a previous anesthetic/diagnostic spinal procedure. 28 days after surgery, neurological deficits improved in six out of eight patients with spinal subdural hematoma. The long-term survivors (median 45 months) reached a median Barthel-Index of 55. The latency between symptom onset and surgery did not correlate with functional outcome in our series. The preoperative neurological state and location of the hematoma correlated positively with early and long term functional outcome.
Conclusions: To the best of our knowledge, the present study is the largest one-institutional study on patients with spinal subdural hematomas evaluated by modern diagnostic imaging tools and treated by microsurgical techniques. With regard to outcome, the preoperative sensorimotor function and spinal level of the subdural hematoma determined the degree of functional recovery.
