• Benedito Jamilson A Pereira, Antônio Nogueira de Almeida, Valéria Marques F Muio, Jean G de Oliveira, Carlos Vanderlei Medeiros de Holanda, and Nair Cléa Fonseca.
• Centro de Neurologia e Neurocirurgia Associados (CENNA), São Paulo-SP, Brazil; Hospital Real e Benemérita Sociedade Portuguesa de Beneficência de São Paulo, São Paulo-SP, Brazil.
• World Neurosurg. 2016 May 1; 89: 574-577.e7.

ObjectivesTo analyze the clinical presentation and outcome of nontraumatic spontaneous acute spinal subdural hematoma by observing the predictors of outcome.Methods/ResultsThis study was based on a case report and systematic review of the international literature. Among the 151 patients, 80 were female and 65 were male (1.25 female/1.0 male). The age distribution ranged from 6 months to 87 years, with a small increase in incidence between the first and second decade of life and a major peak at age 60 years. The difference of proportion of good results between patients with and without established neurologic deficits was: 0.488, 95% confidence interval (95% CI) 0.237-0.648, P = 2.71e-08; coagulopathy was 0.335, 95% CI 0.163-0.508, P = 0.0002; SAH was 0.0539, 95% CI -0.119 to 0.226, P = 0.6529; lumbar puncture/associated diseases was 0.149 95% CI -0.032 to 0.330, P = 0.1171; surgery was 0.0593, 95% CI -0.114 to 0.233, P = 0.5838; and hematoma extension equal or longer than 5 levels was 0.010 95% CI -0.178 to 0.197, P = 1.ConclusionsAlthough mortality and morbidity associated with nontraumatic spontaneous acute spinal subdural hematoma has decreased during the last 2 decades, the disease still carries a mortality rate of approximately1.3% and a morbidity (permanent neurologic deficits) rate of 28%. The main factors affecting the outcome are neurologic status at presentation and coagulopathies.Copyright © 2015 Elsevier Inc. All rights reserved.

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