Acute cervical epidural hematoma: case report.
A 74 year-old patient with a nocturnal onset of neck and chest pain was brought to an emergency clinic. Physical examination and cardiac assessment were normal. Three hours after the addmittance, a flaccid paralysis of the four limbs supervened. Suspecting of an unusual onset of central nervous system infection, a lumbar puncture was performed, yielding 20 ml of normal cerebrospinal fluid. Thirty oinutes after the puncture, the patient completely regained neurological funcion. He was then referred to a General Hospital where a computed tomography (CT) scan was done showing a large cervical epidural bleeding in the posterolateral region of C4/C5 extending to C7/Th1, along with a C6 vertebral body hemangioma. A magnetic resonance imaging revealed the same CT findings. A normal selective angiography of vertebral arteries, carotid arteries and thyreocervical trunk was carried out. Spontaneous spinal epidural hematoma (ASSEH) is a rare but dramatic cause of neurological impairment. In this article we report a fortunate case of complete recovery after an unusual spine cord decompression. We also review the current literature concerning diagnosis and treatment of ASSEH.
Borges
G
G
Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Brasil. gborges@correionet.com.br
Bonilha
L
L
Maldaum
M V
MV
Menezes
J R
JR
Zanardi
V
V
D000208:Acute Disease; D000368:Aged; D019299:Decompression, Surgical; D006407:Hematoma, Epidural, Cranial / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011782:Quadriplegia / Q000209:etiology / Q000601:surgery; D011859:Radiography