title: Spontaneous spinal epidural hematoma at the 16th week of a twin pregnancy.
abstract: Spontaneous spinal epidural hematoma without discernable underlying conditions is a rare complication during pregnancy. We report a pregnant woman who developed the hematoma at 16 weeks of pregnancy; the earliest occurrence ever reported. A 36-year-old Japanese primipara with twins felt shoulder, neck and back pain at 16(+1) weeks with progressive quadriplegia. Magnetic resonance imaging revealed a mass in the C3-7 epidural space, compatible with a spinal epidural hematoma, and decompression was performed 9 h after symptom onset. Rehabilitation started and she gave birth abdominally to healthy twin infants at the 29th week. Motor, sensory and sphincter disturbances remained. This case demonstrates that spinal epidural hematoma can occur even without known underlying conditions and even at an early gestational age.
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan. matsushi@jichi.ac.jp
authors.forename: Shigeki
authors.initials: S
authors.lastname: Matsubara
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Inoue
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takamura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kimura
authors.forename: Satsuki
authors.initials: S
authors.lastname: Okuno
authors.forename: Akifumi
authors.initials: A
authors.lastname: Fujita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Seichi
mesh_terms: D000328:Adult; D019299:Decompression, Surgical; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000601:surgery; D059285:Pregnancy, Twin