Table 1.

Previously reported cases of spontaneous spinal epidural hematoma in hemodialysis patients since 1990 in the English and Japanese literature, including the present case.

Case number [Reference]	Literary language	Reported year	Age/Sex	Duration of HD	Onset	Underlying diseases	Symptoms	Location of the hematoma	Treatment (Operative interval)	Clinical outcome
Case 1 [15]	English	1999	67/F	9 years	During dialysis	HTN AP ADPKD	Back pain followed by complete sensory and motor loss	T8–L2	Surgery (10 h)	Complete recovery
Case 2 [16]	English	2002	61/M	1 year	Off dialysis	DM	Back pain followed by muscle weakness, hypoesthesia below the level T6, anesthesia below the level T10, and absence of sphincter tone	T5–L1	DDAVP administration and surgery (21 h)	Recovery; however, death due to infection 2 months after operation
Case 3 [17]	English	2003	47/F	3 years	N/A	DM	Back pain followed by muscle weakness in lower limbs (1/5*), sensory impairment below the level T4 and positive Babinski reflex on both sides	T3–S1	Surgery (>48 h)	Improvement in muscle strength to 3/5* 1 month after surgery
Case 4 [18]	English	2009	77/F	3 years	Off dialysis	HTN	Neck pain and back pain followed by paresthesia, bilateral lower limb weakness (2/5*), and right upper limb weakness (0/5*)	C2–T9	Surgery (immediately after few hours)	Good recovery in lower limbs (4/5*) and poor recovery in right upper limb
Case 5 [19]	Japanese	1992	60/M	16 years	Off dialysis	CGN	Neck pain followed by quadriplegia and paresthesia below the level C4, bilateral positive Babinski reflex and Wartenberg reflex and positive knee and ankle clonus	C3–T1	Surgery (20 h)	Incomplete recovery; however, the patient could walk using crutches
Case 6 [19]	Japanese	1993	47/F	12 years	During dialysis	N/A	Neck pain followed by complete paralysis in lower limbs and partial paralysis in upper limbs	C3–T2	Surgery (10 h)	Persistent partial paralysis in upper and lower limbs Ventilator-assistance needed
Case 7 [20]	Japanese	1993	61/M	15 years	During farm work	N/A	Neck pain followed by incomplete paralysis, paresthesia in upper and lower limbs, ankle clonus positive bilaterally, exaggeration of DTR and fasciculation in lower limbs	C3–C6	Surgery (29 h)	Impaired skill movement, persistence of numbness distal to wrist joints and inguinal regions
Case 8 [20]	Japanese	1996	54/F	1 year	During dialysis	HCC	Systemic pain followed by incomplete paralysis in upper limbs, complete flaccid paralysis in lower limbs, bladder and rectal disturbance and decreased DTR	C5–T1	Conservative management	Improvement in paralysis starting 11 days after onset, full recovery 4 months after onset Disappearance of hematoma disappeared 2 months after onset
Case 9 [20]	Japanese	2000	63/M	4 years	N/A	DM	Stiff neck, neck pain, chest pain followed by complete quadriplegia and absence of DTR	C2–C5	Surgery (30 h)	Only slight improvement in right upper limb Death due to decubitus infection and worsening general status
Case 10 [21]	Japanese	2009	61/F	N/A	N/A	DM	Neck pain and back pain followed by quadriplegia (right side: 3/5*, left side: 0–1/5*), paresthesia and absence of DTR and sphincter tone	C2–T2	Surgery (18 h)	Upper and lower limb weakness (4/5*) and paresthesia remaining on the left side
Case 11 [The present case]	Japanese	2017	70/M	3 years	Off dialysis	DM HTN	Chest pain and abdominal pain followed by complete hemiplegia and absence of sphincter tone	T8–L5	Conservative management	Complete recovery

^*Motor strength was evaluated based on the manual muscle test score. F – female; M – male; HD – hemodialysis; N/A – not available; HTN – hypertension; AP – angina pectoris; ADPKD – autosomal dominant polycystic kidney disease; DM – diabetes mellitus; CGN – chronic glomerulonephritis; HCC – hepatocellular carcinoma; DTR – deep tendon reflex; DDAVP – 1-desamino-8-arginine vasopressin.