{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T10:56:27Z","timestamp":1775472987558,"version":"3.50.1"},"reference-count":29,"publisher":"Medical Association of Zenica-Doboj","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicinski Glasnik"],"published-print":{"date-parts":[[2017,2,1]]},"abstract":"<jats:p>&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim&amp;lt;\/strong&amp;gt; &amp;lt;br \/&amp;gt;To emphasize the importance of early recognition, diagnostic processing and emergent surgical treatment of spontaneous spinal epidural hematoma (SSEH).&amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Methods &amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt;A 39-year-old female presented with sudden onset of severe pain between the shoulder blades followed by paraparesis and alerted sensibility in the lower extremities. An hour later she developed paraplegia with sensory deficits below ThIV level, absence of patellar reflex, ankle jerk reflex and sphincter dysfunction.&amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;\/strong&amp;gt;&amp;lt;br \/&amp;gt;&amp;lt;span style=&amp;quot;background-color: var(--bs-body-bg); font-weight: var(--bs-body-font-weight); text-align: var(--bs-body-text-align);&amp;quot;&amp;gt;Magnetic resonance imaging (MRI) demonstrated acute &amp;lt;\/span&amp;gt;extensive epidural mass of thoracic spinal segments (ThI-ThIII).&amp;lt;br \/&amp;gt;The patient underwent emergent decompressive laminectomy ThI-ThIII with epidural hematoma evacuation within 24 hours of symptoms onset. After the surgical treatment, because of suspicion on spinal arteriovenous malformation, complete diagnostic evaluation with spinal angiography was done and no form of vascular malformation was found. Idiopathic SSEH was diagnosed. Two months later the patient reached complete neurological improvement.&amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; The SSEH is a rare condition that should be kept in mind in patients presenting with neurological deficit and a sudden&amp;lt;br \/&amp;gt;onset of back pain like it was in our case. For early diagnosis, immediate MRI is essential. Prompt surgical decompression such as laminectomy is an absolute surgical indication widely accepted for patients with progressive neurological deficit. The SSEH should be considered as one of the important differential diagnoses in patients who have developed acute myelopathy.&amp;lt;\/p&amp;gt;<\/jats:p>","DOI":"10.17392\/882-16","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T12:51:43Z","timestamp":1713185503000},"page":"106-110","source":"Crossref","is-referenced-by-count":1,"title":["Management of acute spontaneous thoracic spinal epidural hematoma causing paraplegia"],"prefix":"10.17392","volume":"14","author":[{"given":"Fahrudin","family":"Ali\u0107","sequence":"first","affiliation":[{"name":"Cantonal Hospital Zenica","place":["Zenica,Bosnia and Herzegovina"],"department":["Department of Neurosurgery"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakija","family":"Be\u010duli\u0107","sequence":"additional","affiliation":[{"name":"Cantonal Hospital Zenica","place":["Zenica,Bosnia and Herzegovina"],"department":["Department of Neurosurgery"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldin","family":"Jusi\u0107","sequence":"additional","affiliation":[{"name":"Cantonal Hospital Zenica","place":["Zenica,Bosnia and Herzegovina"],"department":["Department of Neurosurgery"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasim","family":"Skomorac","sequence":"additional","affiliation":[{"name":"Cantonal Hospital Zenica","place":["Zenica,Bosnia and Herzegovina"],"department":["Department of Neurosurgery"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirza","family":"Moranjki\u0107","sequence":"additional","affiliation":[{"name":"University Clinical Center Tuzla","place":["Tuzla,Bosnia and Herzegovina"],"department":["Department of Neurosurgery"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lejla","family":"Hrvat","sequence":"additional","affiliation":[{"name":"Cantonal Hospital Zenica","place":["Zenica,Bosnia and Herzegovina"],"department":["Department of Neurology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lejla","family":"Tandir","sequence":"additional","affiliation":[{"name":"Cantonal Hospital Zenica","place":["Zenica,Bosnia and Herzegovina"],"department":["Department of Neurology"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"49509","published-online":{"date-parts":[[2016,12,1]]},"reference":[{"key":"ref1","first-page":"353","article-title":"Review of 22 cases of spinal epidural hematomas. Prognostic factors and therapeutic management","author":"ATorresA","year":"2004","unstructured":"Torres A, Acebes JJ, Cabiol J, Gabarros A, L\u00f3pez \nL, Plans G, TeixidorP. Review of 22 cases of spinal \nepidural hematomas. Prognostic factors and thera-\npeutic management. Neurocirug\u00eda (Astur) 2004; \n15:353-9.","journal-title":"Neurocirug\u00eda (Astur)"},{"key":"ref2","first-page":"353","article-title":"Spontaneous spinal epidural haematoma associated with aspirin intake","author":"JOhJ","year":"2008","unstructured":"Oh JY, Lingaraj K, Rahmat R. Spontaneous spinal \nepidural haematoma associated with aspirin intake. \nSingapore Med J 2008; 49:e353-5.","journal-title":"Singapore Med J"},{"key":"ref3","first-page":"409","article-title":"Ozgen Multilevel acute spinal epidural hematoma in a patient with chronic renal failure. Case report","author":"IZiyalI","year":"2003","unstructured":"Ziyal IM, Ayd\u0131n S, Inci S, \u015eahin A, Ozgen Mul-\ntilevel acute spinal epidural hematoma in a patient \nwith chronic renal failure. Case report. Neurol Med \nChir (Tokyo) 2003; 43:409-12.","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"ref4","first-page":"408","article-title":"Traumatic epidural hematoma of the cervical spine: magnetic resonance imaging diagnosis and spontaneous resolution: case report","author":"FLefrancF","year":"1999","unstructured":"Lefranc F, David P, Brotchi J, De Witte O. Traumatic \nepidural hematoma of the cervical spine: magnetic \nresonance imaging diagnosis and spontaneous reso-\nlution: case report. Neurosurgery 1999; 44:408-10.","journal-title":"Neurosurgery"},{"key":"ref5","first-page":"31","article-title":"Spontaneous spinal epidural hematoma: a case report and review of the literatures","author":"CLoC","year":"2012","unstructured":"Lo CC, Chen JY, Lo YK, Lai PH, Lin YT. Spontaneo-\nus spinal epidural hematoma: a case report and review \nof the literatures. Acta Neurol Taiwan 2012; 21:31-4.","journal-title":"Acta Neurol Taiwan"},{"key":"ref6","first-page":"540","article-title":"Idiopathic spinal epidural hematoma in patients with sudden paraplegia: a case report","author":"WPaivaW","year":"2008","unstructured":"Paiva WS, Amorim RL, Rusafa E, Taricco MA, Bor-\nSeng-Shu E, Figueiredo EG. Idiopathic spinal epidu-\nral hematoma in patients with sudden paraplegia: a \ncase report. Rev Neurol 2008; 46:540-2.","journal-title":"Rev Neurol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/S0213-4853(10)70033-5","article-title":"Spinal hematomas: spinal apoplexy","author":"PVarela RoisP","year":"2010","unstructured":"Varela Rois P, Gonz\u00e1lez Garc\u00eda J, Regueira Portas \nM, Mart\u00ednez Cueto P, Azevedo Gonz\u00e1lez E. Spi-\nnal hematomas: spinal apoplexy. Neurolog\u00eda 2010; \n25:96-103.","journal-title":"Neurolog\u00eda"},{"key":"ref8","first-page":"325","article-title":"Spinal cord infarction after decompressive laminectomy for spontaneous spinal epidural hematoma-case report","author":"JParkJ","year":"2007","unstructured":"Park J, Lee JB, Park JY, Lim DJ, Kim SD, Chung YK. \nSpinal cord infarction after decompressive laminec-\ntomy for spontaneous spinal epidural hematoma-case \nreport. Neurol Med Chir (Tokyo) 2007; 47:325-7.","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1179\/2045772312Y.0000000001","article-title":"Spontaneous cervical epidural hematoma of idiopathic etiology: case report and review of literature","author":"CGopalkrishnanC","year":"2012","unstructured":"Gopalkrishnan CV, Dhakoji A, Nair S. Spontaneous \ncervical epidural hematoma of idiopathic etiology: \ncase report and review of literature. J Spinal Cord \nMed 2012; 35:113-7.","journal-title":"J Spinal Cord Med"},{"key":"ref10","first-page":"557","article-title":"Is spontaneous spinal epidural hematoma in elderly patients an emergency surgical case?","author":"SSirinS","year":"2010","unstructured":"Sirin S, Arslan E, Yasar S, Kahraman S. Is sponta-\nneous spinal epidural hematoma in elderly patients \nan emergency surgical case? Turk Neurosurg 2010; \n20:557-60.","journal-title":"Turk Neurosurg"},{"key":"ref11","first-page":"227","article-title":"Spontaneous spinal epidural hematoma in a teenage boy with cholestasis: a case report","author":"SDoymazS","year":"2013","unstructured":"Doymaz S, Schneider J. Spontaneous spinal epidural \nhematoma in a teenage boy with cholestasis: a case \nreport. Pediatr Emerg Care 2013; 29:227-9.","journal-title":"Pediatr Emerg Care"},{"key":"ref12","first-page":"59","article-title":"Spontaneous spinal epidural hematoma","author":"Garc\u00edaGarc\u00edaGarc\u00eda","year":"2008","unstructured":"Garc\u00eda Garc\u00eda ME, de Las Heras V, Kurtis Urra M, \nVela Souto I. Spontaneous spinal epidural hemato-\nma. Neurolog\u00eda 2008; 23:59-61.","journal-title":"Neurolog\u00eda"},{"key":"ref13","first-page":"216","article-title":"Spontaneous spinal epidural haematomas and the prognostic implications of interval to surgical decompression: a report of two cases","author":"CWoonC","year":"2009","unstructured":"Woon CY, Peng BC, Chen JL. Spontaneous spinal \nepidural haematomas and the prognostic implicati-\nons of interval to surgical decompression: a report \nof two cases. J Orthop Surg (Hong Kong) 2009; \n17:216-9.","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"ref14","article-title":"Principles of neurological surgery","author":"REllenbogenR","year":"2012","unstructured":"Ellenbogen RG, Abdulrauf SI, Sekhar LN. Princi-\nples of neurological surgery. New York, USA: El-\nsevier, 2012."},{"key":"ref15","first-page":"1490","article-title":"Spontaneous spinal epidural hematoma","author":"WZhongW","year":"2011","unstructured":"Zhong W, Chen H, You C, Li J, Liu Y, Huang S. \nSpontaneous spinal epidural hematoma. J Clin Ne-\nurosci 2011; 18:1490-4.","journal-title":"J Clin Neurosci"},{"key":"ref16","first-page":"5","article-title":"Case of spinal apoplexy","author":"RJacksonR","year":"1969","unstructured":"Jackson R. Case of spinal apoplexy. Lancet 1969; \n2:5-6.","journal-title":"Lancet"},{"key":"ref17","first-page":"45","article-title":"Spontaneous resolution of paraparesis because of acute spontaneous thoracolumbar epidural hematoma","author":"MGundagM","year":"2012","unstructured":"Gundag M, Seyithanoglu MH, Dogan K, Kitis S, \nOzkan N. Spontaneous resolution of paraparesis be-\ncause of acute spontaneous thoracolumbar epidural \nhematoma. Iran Red Crescent Med J 2012; 14:45-8.","journal-title":"Iran Red Crescent Med J"},{"key":"ref18","first-page":"45","article-title":"Spontaneous thoracic spinal epidural hematoma causing paraplegia","author":"KKotilK","year":"2004","unstructured":"Kotil K, Ak\u00c7etin MA, Ku\u015ecuo\u011elu U, Eras M, Acar \nC, Bilge T.Spontaneous thoracic spinal epidural he-\nmatoma causing paraplegia. Turkish Neurosurgery \n2004; 14:45-8.","journal-title":"Turkish Neurosurgery"},{"key":"ref19","first-page":"265","article-title":"Spontaneous spinal epidural haematoma. Etiologic considerations","author":"MWittebolM","year":"1984","unstructured":"Wittebol MC, VanVeelen CWM. Spontaneous spinal \nepidural haematoma. Etiologic considerations. Clin \nNeurol Neurosurg 1984; 86:265-70.","journal-title":"Clin Neurol Neurosurg"},{"key":"ref20","first-page":"143","article-title":"Spontaneous cervical epidural hematoma. A consideration of etiology","author":"RBeattyR","year":"1984","unstructured":"Beatty RM, Winston KR. Spontaneous cervical \nepidural hematoma. A consideration of etiology. \nNeurosurg 1984; 61:143-8.","journal-title":"Neurosurg"},{"key":"ref21","first-page":"395","article-title":"Acute spinal epidural hematoma","author":"ESimmonsE","year":"1978","unstructured":"Simmons EH, Grobler LJ. Acute spinal epidural he-\nmatoma. J. Bone Joint Surg 1978; 60:395-6.","journal-title":"J. Bone Joint Surg"},{"key":"ref22","article-title":"Whizar-Lugo VM","author":"HErbyH","year":"2014. 22 November 2016","unstructured":"Erby HR, SenogluN, AtalayH. Spinal or Epidural \nHaematoma. In: Whizar-Lugo VM, ed. Topics in \nspinal anaesthesia. Chapter 8. 2014. http:\/\/www. \nintechopen.com\/books\/topics-in-spinal-anaesthesia\/ \nspinal-or-epidural-haematoma (22 November 2016)"},{"key":"ref23","article-title":"Textbook of Regional Anesthesia and Acute Pain Management.Part XI. Neurologic Complications of Regional Anesthesia","author":"RJabriR","year":"2007","unstructured":"Jabri RS, Deschner S, Benzon HT. Diagnosis & Ma-\nnagement of Intraspinal, Epidural, & Peripheral Ner-\nve Hematoma. In: Hadzic A, ed. Textbook of Regio-\nnal Anesthesia and Acute Pain Management.Part XI. \nNeurologic Complications of Regional Anesthesia. \nChapter 71.New York: McGraw-Hill Companies, \nInc., 2007."},{"key":"ref24","first-page":"55","article-title":"Spontaneous spinal epidural haematoma--an unusual cause of spinal cord compression","author":"JKongJ","year":"2003","unstructured":"Kong JK, Mak KH. Spontaneous spinal epidural \nhaematoma--an unusual cause of spinal cord com-\npression. Kong Med J 2003; 9:55-7.","journal-title":"Kong Med J"},{"key":"ref25","first-page":"8","article-title":"Nontraumatic spinal epidural hematomas. MR features","author":"KLovbladK","year":"1997","unstructured":"Lovblad KO, Baumgartner RW, Zambaz BD, Re-\nmonda L, Ozdoba C, Schroth G. Nontraumatic spi-\nnal epidural hematomas. MR features. Acta Radiol \n1997; 38:8-13.","journal-title":"Acta Radiol"},{"key":"ref26","first-page":"1322","article-title":"Epidural hematoma after neuraxial blockade: a retrospective report from China","author":"SLiS","year":"2010","unstructured":"Li SL, Wang DX, Ma D. Epidural hematoma af-\nter neuraxial blockade: a retrospective report from \nChina. Anesth Analg 2010; 111:1322-4.","journal-title":"Anesth Analg"},{"key":"ref27","first-page":"172","article-title":"Regional anesthesia in the anticoagulated patient: defining the risks (the second ASRA Consensus Conference on Neuroaxial Anesthesia and Anticoagulation)","author":"THorlockerT","year":"2003","unstructured":"Horlocker TT, Wedel DJ, Benzon H, Brown DL, \nEnneking FK, HeitJ A, Mulroy MF, Rosenquist RW, \nRowlingson J, Tryba M, Yuan CS. Regional anesthe-\nsia in the anticoagulated patient: defining the risks \n(the second ASRA Consensus Conference on Neu-\nroaxial Anesthesia and Anticoagulation). Reg Ane-\nsth Pain Med 2003; 28:172-97.","journal-title":"Reg Anesth Pain Med"},{"key":"ref28","first-page":"334","article-title":"The syndrome of spontaneous spinal epidural hematoma","author":"JMarkhamJ","year":"1967","unstructured":"Markham JW, Lynge HN, Stahlman GEB. The syn-\ndrome of spontaneous spinal epidural hematoma. \nReport of three cases. J Neurosurg 1967; 26:334-42.","journal-title":"J Neurosurg"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1212\/WNL.28.3.224","article-title":"Recovery from paraplegia caused by spontaneous spinal epidural hematoma","author":"IMcquarrieI","year":"1978","unstructured":"McQuarrie IG. Recovery from paraplegia caused by \nspontaneous spinal epidural hematoma. Neurology \n1978; 28:224-8.","journal-title":"Neurology"}],"container-title":["Medicinski Glasnik"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/medicinskiglasnik.ba\/article\/226\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicinskiglasnik.ba\/article\/226\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:43:30Z","timestamp":1775468610000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicinskiglasnik.ba\/article\/id\/47\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12,1]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,2,1]]},"published-print":{"date-parts":[[2017,2,1]]}},"URL":"https:\/\/doi.org\/10.17392\/882-16","archive":["Internet Archive"],"relation":{"is-cited-by":[{"id-type":"doi","id":"10.1007\/s10143-022-01914-0","asserted-by":"object"},{"id-type":"doi","id":"10.1007\/s00381-023-05963-8","asserted-by":"object"}]},"ISSN":["1840-0132","1840-0132"],"issn-type":[{"value":"1840-0132","type":"electronic"},{"value":"1840-0132","type":"print"}],"subject":[],"published":{"date-parts":[[2016,12,1]]}}}