Hemorrhage of the epidural space is a condition in which hemorrhage occurs into the cavity of the intervertebral joint. The epidural surface of the spinal cord is located between the bone and the dura mater of the spinal cord. Hemorrhage can occur as a result of injury, heavy lifting, straining the back muscles, or physical stress such as childbirth. This condition can cause severe pain, which may be due to neurological problems or other associated injuries.
The causes of hemorrhage can be vertebral fractures, compression injuries of the spine, inflammation, metabolic diseases, and infections. Epidural hemorrhages are provoked not only by mechanical (vascular rupture, deformation, hernia), but also by infectious factors (endo-, myelo-, pneumococcal bacteria), metabolic disorders (hyperuricemia). The most dangerous are traumatic epidural hematomas of the cervical spine (in 80% of cases) and the lumbosacral spine. The average age of patients is 46 years (27–75 years). Traumatic hematomas are divided into mechanical and spontaneous. Mechanical epidural hemorrhages occur after injuries or surgical interventions for spinal injuries. Spontaneous epidural hematomas occur in previously ill people without spinal injuries and are often provoked by compression on both sides of the vertebrae by the mass of the tumor, increased intramedullary pressure, vertebral hypermobility, subluxation, and instability of the spinal segment. Most hemorrhages occur in the presence of previous spinal diseases or traumatic injuries.