title: A spinal epidural hematoma with symptoms mimicking cerebral stroke.
abstract: A spontaneous cervical epidural hematoma (SCEH) is a rare condition, which usually requires urgent treatment. However, unusual manifestations, such as hemiparesis, may lead to a misdiagnosis. We herein report a case of SCEH that presented with pure motor hemiparesis to discuss the appropriate and prompt diagnosis and treatment of such cases. An 84-year-old female was brought to our emergency department complaining of nuchal pain, followed by right hemiparesis. A contrast-enhanced computed tomography (CT) scan of the neck demonstrated a spinal epidural hematoma right posterolateral to the spinal cord, extending from C2 to C3. She was managed conservatively and her symptoms improved significantly. The authors emphasize that cervical spinal lesions should be considered in the differential diagnosis for patients with acute onset of hemiparesis, when they are associated with neck pain. Even though magnetic resonance imaging is the gold standard, a CT scan is also useful for quick screening for SCEH.
authors.affiliation: Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan. island@vesta.ocn.ne.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shima
authors.forename: Muneyoshi
authors.initials: M
authors.lastname: Yasuda
authors.forename: Motohiro
authors.initials: M
authors.lastname: Nomura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mori
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Miyashita
authors.forename: Akira
authors.initials: A
authors.lastname: Tamase
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kitamura
authors.forename: Koji
authors.initials: K
authors.lastname: Osuka
authors.forename: Masakazu
authors.initials: M
authors.lastname: Takayasu
mesh_terms: D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D009043:Motor Activity; D019547:Neck Pain / Q000209:etiology; D010291:Paresis / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D020521:Stroke / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed