Unlike the epidural space of the brain, where the dura is quite attached to the overlying bone, the epidural space of the spine is rather large. It contains mostly veins. Injuries to the structures of the spine can lead to bleeding in this region. Therapeutic anticoagulation can lead to bleeding in this space even after mild injuries. Occasionally diagnostic or therapeutic injections into the spine can precipitate bleeding in this layer. When bleeding occurs it may be limited or may form a large blood clot that compresses the adjacent nervous tissue. When the latter happens, varying degrees of weakness, numbness, bowel or bladder dysfunction, and gait disturbances may occur.
Causes of Epidural Hematoma Of The Spine
Injections into the spinal canal may produce bleeding. Anticoagulation may trigger hemorrhages in the epidural space even after minor trauma. Fractures of the spine and tumors in this region both may lead to bleeding in the epidural space. Surgical procedures on the spine may be complicated by post-operative epidural hematomas.
Signs and Symptoms of Epidural Hematoma Of The Spine
The development of an epidural hematoma in the spine is likely to cause local pain and muscle spasms. As the hematoma enlarges, it may produce weakness, numbness and tingling in those regions of the body supplied by that segment of the spinal cord or cauda equina. There may be difficulties with gait and problems with urinating and constipation. If the hemorrhage occurs high in the cervical spine, those muscles necessary for respiration may also be affected leading to shortness of breath. In conditions where the clotting system is not functioning normally, there may be bruising or bleeding in other areas.
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Medical Content Last Updated on 07/12/2008
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