Class A ventral spinal epidural hematoma as a rare complication of hypertensive crisis

Duc Le, Triet Le, Mark Fredrickson, John Norbury
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Abstract

Spinal epidural hematoma is a rare but severe medical condition that can cause neurological deficits and disability. In this case report, a 53-year-old man with poorly controlled hypertension and end-stage renal disease presented with hypertensive crisis and a one-week history of symptoms including back pain, abdominal pain, and pain radiating down his legs. Despite aggressive blood pressure control, the patient was found to have a 21mm ventral epidural hematoma at T10 causing thoracic cord compression and paraplegia. The patient underwent surgical hematoma evacuation but remained paraplegic with minimal motor and sensory recovery. Spinal epidural hematoma as a complication of hypertensive crisis is rare. Clinicians should be aware of the potential development of spinal epidural hematoma in patients with hypertensive crisis, even in cases with no obvious risk factors. Prompt diagnosis and treatment are crucial for preventing permanent neurological damage and improving patient outcomes. Further research is needed to better understand the underlying mechanisms and risk factors for spinal epidural hematoma in patients with hypertensive crisis.
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A类脊髓腹侧硬膜外血肿是高血压危象的罕见并发症
脊髓硬膜外血肿是一种罕见但严重的疾病,可导致神经功能缺损和残疾。在本病例报告中,一名53岁的高血压控制不佳并患有终末期肾病的男性出现高血压危像,并有一周的症状史,包括背痛、腹痛和向下放射到腿部的疼痛。尽管积极控制血压,但患者在T10发现21mm腹侧硬膜外血肿,导致胸脊髓压迫和截瘫。患者接受手术血肿清除,但截瘫,运动和感觉恢复最小。脊髓硬膜外血肿作为高血压危象的并发症是罕见的。即使没有明显的危险因素,临床医生也应该意识到高血压危象患者脊髓硬膜外血肿的潜在发展。及时诊断和治疗对于预防永久性神经损伤和改善患者预后至关重要。需要进一步的研究来更好地了解高血压危象患者脊髓硬膜外血肿的潜在机制和危险因素。
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