title: Spontaneous cervical epidural hematoma of idiopathic etiology: case report and review of literature.
abstract: BACKGROUND
  Spontaneous spinal epidural hematoma (SSEH) is a rare idiopathic condition that leads to acute onset of neurological deficits, which if not recognized early can have catastrophic consequences. The definition and pathophysiology of this condition remain controversial.  High index of suspicion followed by T2-weighted gradient echo sequences are particularly useful in early diagnosis. Management consists of prompt surgical decompression of the hematoma though a recent trend is toward non-surgical treatment.
  
  
  RESULTS
  A 70-year-old man presented  with acute onset neck pain with a radicular component and rapidly progressive quadriparesis. Magnetic resonance imaging revealed a posteriorly located cervical extradural hematoma with cord compression that was promptly evacuated. Functional recovery to near normal function occurred within  24 hours of surgery.
  
  
  CONCLUSIONS
  SSEH in its true idiopathic form is a rare pathologic entity. Because of the high risk of poor outcome without treatment, SSEH should be a diagnostic possibility when presentation is even slightly suggestive. Prompt surgical evacuation of  the hematoma leads to a favorable neurological outcome, whereas delay in treatment can be disastrous. The role of conservative management needs to be proven and should be tailored on an individual basis.
authors.affiliation: Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum, Kerala, India. doc_gopal@yahoo.com
authors.forename: C V
authors.initials: CV
authors.lastname: Gopalkrishnan
authors.forename: Amit
authors.initials: A
authors.lastname: Dhakoji
authors.forename: Suresh
authors.initials: S
authors.lastname: Nair
mesh_terms: D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects*; D046748:Hematoma, Epidural, Spinal / Q000209:etiology*; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D013117:Spinal Cord Compression / Q000601:surgery