{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:13:31Z","timestamp":1777893211292,"version":"3.51.4"},"reference-count":9,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Spontaneous spinal subdural hematoma is rarer and less characterized than epidural hematoma, and comparative data on clinical features and management are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively reviewed cases of spontaneous spinal subdural and epidural hematoma diagnosed between 1995 and 2023 at two tertiary hospitals. Neurological status was graded using the American Spinal Injury Association impairment scale for both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Five subdural and 45 epidural cases were included. Headache occurred in 60% of subdural cases and in none of the epidural cases. Admission blood pressure was lower in the subdural group; time to admission was longer in the subdural group, as was time to diagnosis. Hematoma length was similar (median four vertebral levels) for both populations, but spinal canal occupancy rates were lower in the subdural group. Notably, conservative management was used in 80% of subdural cases versus 46.7% of epidural cases. Interestingly, neurological recovery was comparably favorable in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Subdural and epidural spinal hematomas show distinct presentations and time courses. Headache, delayed presentation, and lower spinal canal occupancy ratios were characteristic of subdural hematomas. Notably, conservative management was appropriate for 80% of spontaneous spinal subdural hematoma but just 46.7% of spontaneous spinal epidural hematoma patients with mild deficits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_230_2026","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:50:16Z","timestamp":1777618216000},"page":"249","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous spinal subdural hematoma: Comparative analysis of clinical features, time course, and outcomes with epidural hematoma"],"prefix":"10.25259","volume":"17","author":[{"given":"Yuma","family":"Hiratsuka","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasufumi","family":"Ohtake","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Senoo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hakodate Neurosurgical Hospital, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirohiko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"10.25259\/SNI_230_2026\/ref-1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/NRL.0000000000000100","article-title":"Spontaneous spinal subdural hematoma","volume":"22","author":"de Beer","year":"2017","journal-title":"Neurologist"},{"key":"10.25259\/SNI_230_2026\/ref-2","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","volume":"35","author":"Gopalkrishnan","year":"2012","journal-title":"J Spinal Cord Med"},{"key":"10.25259\/SNI_230_2026\/ref-3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10143-002-0224-y","article-title":"Spinal hematoma: A literature survey with meta-analysis of 613 patients","volume":"26","author":"Kreppel","year":"2003","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI_230_2026\/ref-4","first-page":"72","article-title":"Spinal subdural haematoma","volume":"5","author":"Manish","year":"2015","journal-title":"J Orthop Case Rep"},{"key":"10.25259\/SNI_230_2026\/ref-5","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1007\/s00701-010-0758-7","article-title":"Spontaneous acute spinal subdural hematoma: Spontaneous recovery from severe paraparesis--case report and review","volume":"152","author":"Payer","year":"2010","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_230_2026\/ref-6","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.wneu.2015.11.010","article-title":"Predictors of outcome in nontraumatic spontaneous acute spinal subdural hematoma: Case report and literature review","volume":"89","author":"Pereira","year":"2016","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_230_2026\/ref-7","first-page":"2431041","article-title":"Acute, nontraumatic spontaneous spinal subdural hematoma: A case report and systematic review of the literature","volume-title":"Case Rep Neurol Med","author":"Rettenmaier","year":"2017"},{"key":"10.25259\/SNI_230_2026\/ref-8","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s12245-021-00379-0","article-title":"Spontaneous spinal epidural hematoma: A case report","volume":"14","author":"Sheng","year":"2021","journal-title":"Int J Emerg Med"},{"key":"10.25259\/SNI_230_2026\/ref-9","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1016\/j.jocn.2011.02.039","article-title":"Spontaneous spinal epidural hematoma","volume":"18","author":"Zhong","year":"2011","journal-title":"J Clin Neurosci"}],"container-title":["Surgical Neurology 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