REVIEW
O hematoma epidural espinhal espontâneo (HEEE) é raro, com etiologia desconhecida e potencial devastador. Além disso, é uma patologia de difícil diagnóstico, sendo fundamental o conhecimento exato dos sinais e sintomas para permitir um bom prognóstico. Realizamos uma revisão sistemática da literatura selecionando artigos publicados até 2021 nas bases de dados da Pubmed, Embase, Web of Science e Scopus sobre HEEE resultando em 2325 estudos clínicos relacionados ao diagnóstico principal, em que foram descritas etiologias, tratamentos e desfechos. Uma busca minuciosa desses artigos sugere que malformações vasculares, terapia anticoagulante, neoplasias e cirurgia espinhal prévia são as causas mais comuns de HEEE. O principal método diagnóstico de HEEE é uma história completa do paciente e exames de imagem, principalmente a ressonância magnética. Além disso, o tratamento cirúrgico é indicado para a maioria dos casos, consistindo em descompressão cirúrgica e evacuação do hematoma, com tratamento conservador recomendado para poucos casos selecionados com evidências, sugerindo que o tempo cirúrgico influencia o prognóstico.
Spontaneous Spinal Epidural Hematoma (SSEH) is rare, with unknown etiology and devastating potential. Also, it is a pathology of difficult diagnosis, the exact knowledge of signs and symptoms is fundamental to allow a good prognosis. A systematized review of the literature was performed selecting articles published until 2021 in Pubmed, Embase, Web of Science, and Scopus databases about SSEH resulting in 2325 clinical studies related to the main diagnosis, and its etiologies, treatments and outcomes were described. A thorough search of these articles suggests that vascular malformations, anticoagulant therapy, neoplasms, and previous spinal surgery are the most common causes of SSEH and the main diagnostic method of SSEH is a thorough patient history and imaging studies, mainly MRI. Moreover, surgical treatment is indicated for most of cases, consisting of surgical decompression and hematoma evacuation, with conservative treatment recommended for fewer, selected cases with pieces of evidence suggesting that surgical timing influences the prognosis.
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1 Medical student, Neurosurgery Department, Atenas University Center, Passos, MG, Brazil.
2 Medical student, Federal University of Rio de Janeiro, Faculty of Medicine, Rio de Janeiro, RJ, Brazil.
3 Medical student, Vanderbilt University School of Medicine, Nashville, TN, USA.
4 Medical student, Neurosurgery Department, Atenas University Center, Sete Lagoas, MG, Brazil.
5 MD, Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil.
6 MD, Neurosurgeon, Department of Neurosurgery, Hospital Força Aérea do Galeão, Rio de Janeiro, RJ, Brazil.
7 MD, MSc, Neurosurgeon, Department of Neurosurgery, Hospital Força Aérea do Galeão, Rio de Janeiro, RJ, Brazil.
Received Jun 2, 2022
Accepted Jul 12, 2022
