Background

There is a lack of evidence on spinal subarachnoid hematomas because of the rarity of their spontaneous development and difficulty in diagnosis. The aim of this study was to identify the characteristics and outcomes of surgically confirmed acute non-traumatic spinal subarachnoid hematomas from a multicenter surgical database and conduct a systematic review of existing literature.

Methods

Five surgically confirmed cases of acute non-traumatic spinal subarachnoid hematomas were identified from our multicenter database with 22 cases from a systematic review of existing literature.

Results

The mean age of the 27 patients was 59 years. The length of the hematoma was longer than five vertebrae in 70% of the patients, most commonly distributed in the thoracic spine; 63% of all cases were idiopathic, 30% were under anticoagulant therapy, and the remaining 7% presented with coagulation abnormalities. As many as 70% of the patients showed some improvement in neurological symptoms after surgery during a mean follow-up period of 14 months.

Conclusions

This study elucidated the characteristics of acute non-traumatic spinal subarachnoid hematomas in patients who were surgically confirmed. Most patients were middle-aged, complained of back pain, and had the hematoma located in the thoracic spine. Seventy percent of the patients in this study had some improvement in their neurological status, most likely due to surgical decompression and hematoma evacuation.

中文翻译：

---

急性非外伤性脊柱蛛网膜下腔血肿五例报告及系统文献复习

背景

由于脊髓蛛网膜下腔血肿很少自发发生且诊断困难，因此缺乏证据。本研究的目的是从多中心手术数据库中确定经手术证实的急性非创伤性脊髓蛛网膜下腔血肿的特征和结果，并对现有文献进行系统回顾。

方法

我们的多中心数据库中确定了 5 例经手术确诊的急性非创伤性脊髓蛛网膜下腔血肿病例，其中 22 例来自对现有文献的系统回顾。

结果

27 名患者的平均年龄为 59 岁。70%的患者血肿长度超过5块椎骨，最常见分布于胸椎；所有病例中 63% 为特发性，30% 正在接受抗凝治疗，其余 7% 出现凝血异常。在平均 14 个月的随访期内，多达 70% 的患者在手术后神经系统症状有所改善。

结论

本研究阐明了经手术证实的急性非创伤性脊髓蛛网膜下腔血肿的特征。大多数患者是中年人，主诉背痛，血肿位于胸椎。本研究中 70% 的患者神经系统状态有所改善，这很可能是由于手术减压和血肿清除所致。