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Intramedullary Spinal Cord Hematoma - Best Hospitals, Doctors, Prices - Booking Health

Treatment of Intramedullary Spinal Cord Hematoma

Intramedullary spinal cord hematoma | Information about hospitals and doctors | Rankings | Clinics | Prices | Send request to the hospital

Best hospitals and doctors for intramedullary spinal cord hematoma treatment abroad

Leading hospitals

Cost for treatment

Diagnostic tests for intramedullary spinal cord hematoma
2471
Treatment of intramedullary spinal cord hematoma with surgical removal
7576.31
Neurological rehabilitation Phase C
0.00
The Catholic Clinic Koblenz-Montabaur is a modern medical facility with an excellent reputation in Germany and abroad. The medical center is an academic clinic of the University Hospital Mainz, which gives patients the opportunity to take advantage of scientific advances and innovative treatments. The clinic has the widest possi
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According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
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The University Hospital Freiburg is famous for its rich history and is one of the oldest and most prestigious medical facilities in Germany (one of the three best medical institutions in the country). The hospital was based on the Faculty of Medicine of the Albert Ludwig University of Freiburg, which celebrated its 550th anniver
According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
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According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
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University Hospital Ulm

University Hospital Ulm

Overall rating8.7 / 10
The University Hospital Ulm is an advanced medical complex that provides patients with high-class medical care using the very latest scientific achievements. The medical facility has been performing successful clinical activities for more than 40 years and has long earned an excellent reputation throughout Europe. The hospital r
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According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
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According to the reputable Focus magazine, the University Hospital Carl Gustav Carus Dresden ranks among the top five German hospitals! The hospital is the benchmark for modern high-quality medicine. Positioning itself as a maximum care medical facility, the hospital represents all medical fields. There are 26 specialized depart
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According to the Focus magazine, the University Hospital Hamburg-Eppendorf ranks among the top ten hospitals in Germany! Since its foundation in 1889, the hospital has taken a leading position in the European medical arena and still occupies it until today. A highly competent medical team of more than 11,000 employees takes care
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According to the Focus magazine, the University Hospital Muenster ranks among the top German hospitals! The hospital belongs to the most prestigious medical institutions in Germany. The hospital is distinguished by a high professionalism of its doctors, state-of-the-art technological equipment and the availability of the most ad
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University Hospital Jena

University Hospital Jena

Overall rating8.9 / 10
According to the prestigious Focus magazine, the University Hospital Jena regularly ranks among the top German medical facilities! The hospital has positioned itself as a multidisciplinary medical facility with a long history of more than 200 years. Since its foundation, the hospital has been constantly developing and modernizin
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The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
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The University Hospital Rechts der Isar Munich was founded in 1834. It combines long traditions with the very latest advances in modern medicine. The medical facility includes 33 specialized departments and 20 interdisciplinary centers, where patients can receive top-class medical care in all medical fields. The hospital annuall
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According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
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According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
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According to the prestigious medical publication Focus, the University Hospital Tuebingen ranks among the top five German hospitals! The hospital was founded in 1805, therefore it is proud of its long history, unique experience, and outstanding achievements in the field of medical care, as well as research and teaching activitie
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Intramedullary hematoma is an accumulation of blood that has formed in the matter of the spinal cord. The pathology is often combined with vertebral damage and meningeal hemorrhages. The treatment can be either conservative or surgical. An operation to remove the hematoma is required in cases of significant spinal cord compression, which can lead to a severe and irreversible neurological deficit.

Content

  1. Causes
  2. Symptoms
  3. Diagnostics
  4. Treatment

Causes 

 

Intramedullary hematoma is usually the result of a spinal injury. It is often accompanied by other injuries – vertebral fractures, injuries of other organs. At the same time, hematomas can form outside the matter of the spinal cord: subdural and epidural.

Other causes are less common. These can be:

  • Hemorrhagic spinal stroke.
  • Tumors. 
  • Previous surgical procedures. 
  • Coagulopathy or taking anticoagulants.
  • Arteriovenous malformations.
  • Vasculitis. 
  • Leukemia.

According to the mechanism of the formation of the hematoma, there are three main causes: the effect of excessive force, a violation of blood clotting, or a pathology that increases the likelihood of rupture of blood vessels.

Symptoms 

 

Large foci of hemorrhage are more often formed in the grey matter – it is looser and richer in blood vessels. Its affection causes the development of focal neurological symptoms. Their specifics with hematoma is the sudden appearance and localization mainly on the one side. Typically, the hematoma spans from 2 to 5 segments.

Clinical manifestations depend on the location of the hematoma. The hemorrhage mostly occurs in the region of the central canal of the posterior horns. In this case, pain and temperature sensitivity is impaired. With the formation of the hematoma in the area of the anterior horns, flaccid paresis and muscle atrophy are observed. Pain and worsening of urination control are possible.

In the acute period of the hematoma, even if the focus of hemorrhage itself is small, edema and inflammation always join. Symptoms reach their maximum severity on days 7-10. Then the hematoma begins to dissolve, and the neurological manifestations gradually regress.

Spinal cord intramedullary hematoma is not always isolated. It can come together with meningeal hemorrhages. They are of two types:

  • Subarachnoid.
  • Epidural. 

Subarachnoid hemorrhage is more common. It is manifested by intense back pain, increased tone of the occipital muscles, sensory and pelvic disorders.

Epidural hemorrhage is rare. The main symptom is pain. These hematomas can be large and sometimes cause transverse compression of the spinal cord.

Diagnostics 

 

Patients undergo a neurological diagnostic examination. Doctors study their medical history. 

The main method of instrumental diagnostics of hematoma is computed tomography. It is carried out with the use of contrast agents. The CT scan is quick and can be performed even for a seriously ill patient who has recently suffered a spinal injury. For the patients with severe back pain, the CT scan is conducted under sedation.

With the help of computed tomography, the doctor can assess the location of the hematoma, its size, compression of the spinal cord structures, the presence of edema and inflammation. It is possible to determine the causes for the formation of the hematoma, if they have not yet been established. For example, a doctor may find a tumor or an arteriovenous malformation. With spinal injury, the specialists determine the degree of damage to the vertebrae and surrounding tissues.

In a long-term period after an injury or other disease that led to the formation of the hematoma, MRI is considered a more informative method. The technique also makes it possible to evaluate secondary degenerative changes in the spinal cord, which can progress even several months or years after the hemorrhage.

Laboratory methods are of secondary importance. If concomitant subarachnoid hemorrhage is suspected, a lumbar puncture is performed. Blood can be found in the cerebrospinal fluid. A coagulogram and a complete blood count help assess blood clotting and determine platelet levels.

Treatment 

 

First of all, treatment is aimed at eliminating the underlying disease. The hematoma is just one of its manifestations.

The hematoma itself does not always require treatment. Small foci of the hemorrhage resolve on their own. To speed up this process and prevent complications, drug therapy is used.

Although the hematoma disappears over time, recovery of spinal cord function is rarely complete. Weakness in the limbs, muscle atrophy, sensory disorders, urinary incontinence may persist as well. The patients after a previous illness require rehabilitation to prevent disability and improve the quality of life.

With the intramedullary hematoma of the spinal cord, grade 4, a surgical intervention is required. It is important to avoid compression of the spinal cord, as the compressed areas die off and an irreversible neurological deficit develops. In severe cases, complete transverse compression of the spinal cord can occur.

The treatment involves the use of laminectomy – the doctor removes the vertebral arches and eliminates the blood accumulated in the spinal cord. After the operation, neurological symptoms quickly regress.

Additional treatment of the underlying diseases can be required. These can be: 

  • Correction of coagulopathy, erythrocyte transfusion.
  • Removal of the tumor that caused the bleeding.
  • Reposition of bone fragments in case of injury.
  • Removal of arteriovenous malformations, their clipping or endovascular embolization.
  • Chemotherapy for leukemia, etc.

For the prevention of infectious complications, antibiotics are used. In addition, many patients require intensive care and vital signs monitoring.

To undergo treatment of intramedullary hematoma of the spinal cord abroad, please use the services of Booking Health. We will help you find the most suitable spinal cord hematoma treatment clinics and take care of the organization of your trip. On the Booking Health website, you can compare prices for surgical removal of hematoma with decompression and book a medical care program at a favorable price. The cost of treatment for you will be lower due to the lack of additional coefficients for foreign patients.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko