Epidural hematoma pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
Epidural hematoma is the result of the bleeding within the [[epidural space]], which lies between [[dura mater]] and [[Skull|skull bone]]. The main cause of epidural hematoma is typically [[head injury]] that results in a break of the [[temporal bone]] and bleeding from the [[middle meningeal artery]] in the [[epidural space]]. Because the bleeding is caused by arterial rupture, it has a high tendency to progress and it causes a [[hematoma]] in [[epidural space]]. Progression of bleeding may expand the [[hematoma]] and cause increasing of the [[intracranial pressure]] and it may lead to [[brain herniation]]. Occasionally epidural hematoma may occur as a result of a [[Bleeding disorders]] or blood vessel [[malformation]] or after [[CNS]] surgery or [[lumbar]] [[Acupuncture|acupunctures]] or Spinal injections or [[metastatic cancer]] and sometimes is may occur spontaneously. | |||
==Pathophysiology== | ==Pathophysiology== | ||
===Pathogenesis=== | ===Pathogenesis=== | ||
* Epidural hematoma is the result of the bleeding within the epidural space, which lies between dura mater and skull bone. | * Epidural hematoma is the result of the bleeding within the [[epidural space]], which lies between [[dura mater]] and [[Skull|skull bone]].<ref name="pmid22325415">{{cite journal| author=Scheibl A, Calderón EM, Borau MJ, Prieto RM, González PF, Galiana GG| title=Epidural hematoma. | journal=J Pediatr Surg | year= 2012 | volume= 47 | issue= 2 | pages= e19-21 | pmid=22325415 | doi=10.1016/j.jpedsurg.2011.10.078 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22325415 }} </ref> | ||
* The main cause of epidural hematoma is typically head injury that results in a break of the temporal bone and bleeding from the middle meningeal artery in the epidural space. | * The main cause of epidural hematoma is typically [[head injury]] that results in a break of the [[temporal bone]] and bleeding from the [[middle meningeal artery]] in the [[epidural space]].<ref name="pmid27766029">{{cite journal| author=Yu J, Guo Y, Xu B, Xu K| title=Clinical importance of the middle meningeal artery: A review of the literature. | journal=Int J Med Sci | year= 2016 | volume= 13 | issue= 10 | pages= 790-799 | pmid=27766029 | doi=10.7150/ijms.16489 | pmc=5069415 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27766029 }} </ref><ref name="pmid17639868">{{cite journal| author=Yanagawa Y, Sakamoto T, Okada Y| title=Clinical features of temporal tip epidural hematomas. | journal=J Neurosurg | year= 2007 | volume= 107 | issue= 1 | pages= 18-20 | pmid=17639868 | doi=10.3171/JNS-07/07/0018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17639868 }} </ref><ref name="pmid26567227">{{cite journal| author=Maugeri R, Anderson DG, Graziano F, Meccio F, Visocchi M, Iacopino DG| title=Conservative vs. Surgical Management of Post-Traumatic Epidural Hematoma: A Case and Review of Literature. | journal=Am J Case Rep | year= 2015 | volume= 16 | issue= | pages= 811-7 | pmid=26567227 | doi= | pmc=4652627 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26567227 }} </ref><ref name="pmid15686177">{{cite journal| author=Mitsuyama T, Ide M, Kawamura H| title=Acute epidural hematoma caused by contrecoup head injury--case report. | journal=Neurol Med Chir (Tokyo) | year= 2004 | volume= 44 | issue= 11 | pages= 584-6 | pmid=15686177 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15686177 }} </ref> | ||
* Because the bleeding is caused by arterial rupture, it has a high tendency to progress and it causes a | * Because the bleeding is caused by arterial rupture, it has a high tendency to progress and it causes a [[hematoma]] in [[epidural space]]. | ||
* Progression of bleeding may expand the hematoma and cause increasing of the intracranial pressure and it may lead to brain herniation. | * Progression of bleeding may expand the [[hematoma]] and cause increasing of the [[intracranial pressure]] and it may lead to [[brain herniation]].<ref name="pmid23320175">{{cite journal| author=Chen H, Guo Y, Chen SW, Wang G, Cao HL, Chen J et al.| title=Progressive epidural hematoma in patients with head trauma: incidence, outcome, and risk factors. | journal=Emerg Med Int | year= 2012 | volume= 2012 | issue= | pages= 134905 | pmid=23320175 | doi=10.1155/2012/134905 | pmc=3536037 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23320175 }} </ref> | ||
* Occasionally epidural hematoma may occur as a result of a | * Occasionally epidural hematoma may occur as a result of a [[Bleeding disorders]] or blood vessel [[malformation]] or after [[CNS]] surgery or [[lumbar]] [[Acupuncture|acupunctures]] or Spinal injections or [[metastatic cancer]] and sometimes is may occur spontaneously.<ref name="pmid20221963">{{cite journal| author=Morsing IE, Brons P, Th Draaisma JM, van Lindert EJ, Erasmus CE| title=Hemophilia a and spinal epidural hematoma in children. | journal=Neuropediatrics | year= 2009 | volume= 40 | issue= 5 | pages= 245-8 | pmid=20221963 | doi=10.1055/s-0030-1248247 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20221963 }} </ref><ref name="pmid23812629">{{cite journal| author=Paraskevopoulos D, Magras I, Polyzoidis K| title=Spontaneous spinal epidural hematoma secondary to extradural arteriovenous malformation in a child: a case-based update. | journal=Childs Nerv Syst | year= 2013 | volume= 29 | issue= 11 | pages= 1985-91 | pmid=23812629 | doi=10.1007/s00381-013-2214-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23812629 }} </ref><ref name="pmid21165315">{{cite journal| author=Kim B, Moon SH, Kim SY, Kim HJ, Lee HM| title=Delayed Spinal Epidural Hematoma after En Block Spondylectomy for Vertebral Ewing's Sarcoma. | journal=Asian Spine J | year= 2010 | volume= 4 | issue= 2 | pages= 118-22 | pmid=21165315 | doi=10.4184/asj.2010.4.2.118 | pmc=2996623 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21165315 }} </ref><ref name="pmid9226976">{{cite journal| author=Chen CY, Liu GC, Sheu RS, Huang CL| title=Bacterial meningitis and lumbar epidural hematoma due to lumbar acupunctures: a case report. | journal=Kaohsiung J Med Sci | year= 1997 | volume= 13 | issue= 5 | pages= 328-31 | pmid=9226976 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9226976 }} </ref><ref name="pmid9952124">{{cite journal| author=Simmons NE, Elias WJ, Henson SL, Laws ER| title=Small cell lung carcinoma causing epidural hematoma: case report. | journal=Surg Neurol | year= 1999 | volume= 51 | issue= 1 | pages= 56-9 | pmid=9952124 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9952124 }} </ref> | ||
== | |||
==Associated Conditions== | ==Associated Conditions== | ||
*[[Head trauma]]<ref name="pmid15686177">{{cite journal| author=Mitsuyama T, Ide M, Kawamura H| title=Acute epidural hematoma caused by contrecoup head injury--case report. | journal=Neurol Med Chir (Tokyo) | year= 2004 | volume= 44 | issue= 11 | pages= 584-6 | pmid=15686177 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15686177 }} </ref><ref name="pmid26567227">{{cite journal| author=Maugeri R, Anderson DG, Graziano F, Meccio F, Visocchi M, Iacopino DG| title=Conservative vs. Surgical Management of Post-Traumatic Epidural Hematoma: A Case and Review of Literature. | journal=Am J Case Rep | year= 2015 | volume= 16 | issue= | pages= 811-7 | pmid=26567227 | doi= | pmc=4652627 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26567227 }} </ref> | |||
== | *[[Bleeding disorders]]<ref name="pmid20221963">{{cite journal| author=Morsing IE, Brons P, Th Draaisma JM, van Lindert EJ, Erasmus CE| title=Hemophilia a and spinal epidural hematoma in children. | journal=Neuropediatrics | year= 2009 | volume= 40 | issue= 5 | pages= 245-8 | pmid=20221963 | doi=10.1055/s-0030-1248247 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20221963 }} </ref> | ||
* | *Blood vessel [[malformation]]<ref name="pmid23812629">{{cite journal| author=Paraskevopoulos D, Magras I, Polyzoidis K| title=Spontaneous spinal epidural hematoma secondary to extradural arteriovenous malformation in a child: a case-based update. | journal=Childs Nerv Syst | year= 2013 | volume= 29 | issue= 11 | pages= 1985-91 | pmid=23812629 | doi=10.1007/s00381-013-2214-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23812629 }} </ref> | ||
*[[CNS]] surgery<ref name="pmid21165315">{{cite journal| author=Kim B, Moon SH, Kim SY, Kim HJ, Lee HM| title=Delayed Spinal Epidural Hematoma after En Block Spondylectomy for Vertebral Ewing's Sarcoma. | journal=Asian Spine J | year= 2010 | volume= 4 | issue= 2 | pages= 118-22 | pmid=21165315 | doi=10.4184/asj.2010.4.2.118 | pmc=2996623 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21165315 }} </ref> | |||
== | *[[Sickle Cell Anemia]]<ref name="pmid23741596">{{cite journal| author=Babatola BO, Salman YA, Abiola AM, Okezie KO, Oladele AS| title=Spontaneous epidural haematoma in sickle cell anaemia: case report and literature review. | journal=J Surg Tech Case Rep | year= 2012 | volume= 4 | issue= 2 | pages= 135-7 | pmid=23741596 | doi=10.4103/2006-8808.110271 | pmc=3673360 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23741596 }} </ref><ref name="pmid26576305">{{cite journal| author=Yogarajah M, Agu CC, Sivasambu B, Mittler MA| title=HbSC Disease and Spontaneous Epidural Hematoma with Kernohan's Notch Phenomena. | journal=Case Rep Hematol | year= 2015 | volume= 2015 | issue= | pages= 470873 | pmid=26576305 | doi=10.1155/2015/470873 | pmc=4631867 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26576305 }} </ref> | ||
* | *[[Kummell disease|Kummell's disease]]<ref name="pmid21607183">{{cite journal| author=Kim HS, Lee SK, Kim SW, Shin H| title=Chronic Spinal Epidural Hematoma Related to Kummell's Disease. | journal=J Korean Neurosurg Soc | year= 2011 | volume= 49 | issue= 4 | pages= 231-3 | pmid=21607183 | doi=10.3340/jkns.2011.49.4.231 | pmc=3098428 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21607183 }} </ref> | ||
*[[Dengue virus|Dengue virus infection]]<ref name="pmid26900103">{{cite journal| author=Fong CY, Hlaing CS, Tay CG, Kadir KA, Goh KJ, Ong LC| title=Longitudinal extensive transverse myelitis with cervical epidural haematoma following dengue virus infection. | journal=Eur J Paediatr Neurol | year= 2016 | volume= 20 | issue= 3 | pages= 449-53 | pmid=26900103 | doi=10.1016/j.ejpn.2016.01.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26900103 }} </ref> | |||
*[[Lumbar]] [[acupuncture]]<nowiki/>s<ref name="pmid9226976">{{cite journal| author=Chen CY, Liu GC, Sheu RS, Huang CL| title=Bacterial meningitis and lumbar epidural hematoma due to lumbar acupunctures: a case report. | journal=Kaohsiung J Med Sci | year= 1997 | volume= 13 | issue= 5 | pages= 328-31 | pmid=9226976 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9226976 }} </ref> | |||
*Spinal injections<ref name="pmid15041581">{{cite journal| author=Rosen DA, Hawkinberry DW, Rosen KR, Gustafson RA, Hogg JP, Broadman LM| title=An epidural hematoma in an adolescent patient after cardiac surgery. | journal=Anesth Analg | year= 2004 | volume= 98 | issue= 4 | pages= 966-9, table of contents | pmid=15041581 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15041581 }} </ref><ref name="pmid22220233">{{cite journal| author=Bang J, Kim JU, Lee YM, Joh J, An EH, Lee JY et al.| title=Spinal epidural hematoma related to an epidural catheter in a cardiac surgery patient -A case report-. | journal=Korean J Anesthesiol | year= 2011 | volume= 61 | issue= 6 | pages= 524-7 | pmid=22220233 | doi=10.4097/kjae.2011.61.6.524 | pmc=3249578 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22220233 }} </ref> | |||
*[[Metastatic cancer]]<ref name="pmid9952124">{{cite journal| author=Simmons NE, Elias WJ, Henson SL, Laws ER| title=Small cell lung carcinoma causing epidural hematoma: case report. | journal=Surg Neurol | year= 1999 | volume= 51 | issue= 1 | pages= 56-9 | pmid=9952124 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9952124 }} </ref> | |||
__NOTOC__ | __NOTOC__ | ||
Latest revision as of 15:52, 30 May 2018
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Epidural hematoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Epidural hematoma pathophysiology On the Web |
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American Roentgen Ray Society Images of Epidural hematoma pathophysiology |
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Risk calculators and risk factors for Epidural hematoma pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
Epidural hematoma is the result of the bleeding within the epidural space, which lies between dura mater and skull bone. The main cause of epidural hematoma is typically head injury that results in a break of the temporal bone and bleeding from the middle meningeal artery in the epidural space. Because the bleeding is caused by arterial rupture, it has a high tendency to progress and it causes a hematoma in epidural space. Progression of bleeding may expand the hematoma and cause increasing of the intracranial pressure and it may lead to brain herniation. Occasionally epidural hematoma may occur as a result of a Bleeding disorders or blood vessel malformation or after CNS surgery or lumbar acupunctures or Spinal injections or metastatic cancer and sometimes is may occur spontaneously.
Pathophysiology
Pathogenesis
- Epidural hematoma is the result of the bleeding within the epidural space, which lies between dura mater and skull bone.[1]
- The main cause of epidural hematoma is typically head injury that results in a break of the temporal bone and bleeding from the middle meningeal artery in the epidural space.[2][3][4][5]
- Because the bleeding is caused by arterial rupture, it has a high tendency to progress and it causes a hematoma in epidural space.
- Progression of bleeding may expand the hematoma and cause increasing of the intracranial pressure and it may lead to brain herniation.[6]
- Occasionally epidural hematoma may occur as a result of a Bleeding disorders or blood vessel malformation or after CNS surgery or lumbar acupunctures or Spinal injections or metastatic cancer and sometimes is may occur spontaneously.[7][8][9][10][11]
Associated Conditions
- Head trauma[5][4]
- Bleeding disorders[7]
- Blood vessel malformation[8]
- CNS surgery[9]
- Sickle Cell Anemia[12][13]
- Kummell's disease[14]
- Dengue virus infection[15]
- Lumbar acupunctures[10]
- Spinal injections[16][17]
- Metastatic cancer[11]
|
Epidural hematoma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Epidural hematoma pathophysiology On the Web |
|
American Roentgen Ray Society Images of Epidural hematoma pathophysiology |
|
Risk calculators and risk factors for Epidural hematoma pathophysiology |
Overview
References
- ↑ Scheibl A, Calderón EM, Borau MJ, Prieto RM, González PF, Galiana GG (2012). "Epidural hematoma". J Pediatr Surg. 47 (2): e19–21. doi:10.1016/j.jpedsurg.2011.10.078. PMID 22325415.
- ↑ Yu J, Guo Y, Xu B, Xu K (2016). "Clinical importance of the middle meningeal artery: A review of the literature". Int J Med Sci. 13 (10): 790–799. doi:10.7150/ijms.16489. PMC 5069415. PMID 27766029.
- ↑ Yanagawa Y, Sakamoto T, Okada Y (2007). "Clinical features of temporal tip epidural hematomas". J Neurosurg. 107 (1): 18–20. doi:10.3171/JNS-07/07/0018. PMID 17639868.
- ↑ 4.0 4.1 Maugeri R, Anderson DG, Graziano F, Meccio F, Visocchi M, Iacopino DG (2015). "Conservative vs. Surgical Management of Post-Traumatic Epidural Hematoma: A Case and Review of Literature". Am J Case Rep. 16: 811–7. PMC 4652627. PMID 26567227.
- ↑ 5.0 5.1 Mitsuyama T, Ide M, Kawamura H (2004). "Acute epidural hematoma caused by contrecoup head injury--case report". Neurol Med Chir (Tokyo). 44 (11): 584–6. PMID 15686177.
- ↑ Chen H, Guo Y, Chen SW, Wang G, Cao HL, Chen J; et al. (2012). "Progressive epidural hematoma in patients with head trauma: incidence, outcome, and risk factors". Emerg Med Int. 2012: 134905. doi:10.1155/2012/134905. PMC 3536037. PMID 23320175.
- ↑ 7.0 7.1 Morsing IE, Brons P, Th Draaisma JM, van Lindert EJ, Erasmus CE (2009). "Hemophilia a and spinal epidural hematoma in children". Neuropediatrics. 40 (5): 245–8. doi:10.1055/s-0030-1248247. PMID 20221963.
- ↑ 8.0 8.1 Paraskevopoulos D, Magras I, Polyzoidis K (2013). "Spontaneous spinal epidural hematoma secondary to extradural arteriovenous malformation in a child: a case-based update". Childs Nerv Syst. 29 (11): 1985–91. doi:10.1007/s00381-013-2214-5. PMID 23812629.
- ↑ 9.0 9.1 Kim B, Moon SH, Kim SY, Kim HJ, Lee HM (2010). "Delayed Spinal Epidural Hematoma after En Block Spondylectomy for Vertebral Ewing's Sarcoma". Asian Spine J. 4 (2): 118–22. doi:10.4184/asj.2010.4.2.118. PMC 2996623. PMID 21165315.
- ↑ 10.0 10.1 Chen CY, Liu GC, Sheu RS, Huang CL (1997). "Bacterial meningitis and lumbar epidural hematoma due to lumbar acupunctures: a case report". Kaohsiung J Med Sci. 13 (5): 328–31. PMID 9226976.
- ↑ 11.0 11.1 Simmons NE, Elias WJ, Henson SL, Laws ER (1999). "Small cell lung carcinoma causing epidural hematoma: case report". Surg Neurol. 51 (1): 56–9. PMID 9952124.
- ↑ Babatola BO, Salman YA, Abiola AM, Okezie KO, Oladele AS (2012). "Spontaneous epidural haematoma in sickle cell anaemia: case report and literature review". J Surg Tech Case Rep. 4 (2): 135–7. doi:10.4103/2006-8808.110271. PMC 3673360. PMID 23741596.
- ↑ Yogarajah M, Agu CC, Sivasambu B, Mittler MA (2015). "HbSC Disease and Spontaneous Epidural Hematoma with Kernohan's Notch Phenomena". Case Rep Hematol. 2015: 470873. doi:10.1155/2015/470873. PMC 4631867. PMID 26576305.
- ↑ Kim HS, Lee SK, Kim SW, Shin H (2011). "Chronic Spinal Epidural Hematoma Related to Kummell's Disease". J Korean Neurosurg Soc. 49 (4): 231–3. doi:10.3340/jkns.2011.49.4.231. PMC 3098428. PMID 21607183.
- ↑ Fong CY, Hlaing CS, Tay CG, Kadir KA, Goh KJ, Ong LC (2016). "Longitudinal extensive transverse myelitis with cervical epidural haematoma following dengue virus infection". Eur J Paediatr Neurol. 20 (3): 449–53. doi:10.1016/j.ejpn.2016.01.012. PMID 26900103.
- ↑ Rosen DA, Hawkinberry DW, Rosen KR, Gustafson RA, Hogg JP, Broadman LM (2004). "An epidural hematoma in an adolescent patient after cardiac surgery". Anesth Analg. 98 (4): 966–9, table of contents. PMID 15041581.
- ↑ Bang J, Kim JU, Lee YM, Joh J, An EH, Lee JY; et al. (2011). "Spinal epidural hematoma related to an epidural catheter in a cardiac surgery patient -A case report-". Korean J Anesthesiol. 61 (6): 524–7. doi:10.4097/kjae.2011.61.6.524. PMC 3249578. PMID 22220233.