title: Spontaneous spinal epidural hematoma in infancy: review of the literature and the "seventh" case report.
abstract: Spontaneous spinal epidural hematomas (SSEH) are a rare cause of spinal cord compression in childhood and especially in infancy. We reviewed the literature and describe a case of an 8-month-old boy with a large spontaneous cervico-thoracic epidural hematoma. With this review we want to detail the importance of early investigation, diagnosis and treatment in infants with SSEH. In our case the infant presented with irritability and crying and an ascending paralysis within four days. Magnetic resonance imaging (MRI) of the spine demonstrated an extensive epidural hematoma between C5 and L1, serious medullar compression and secondary cervical and thoracic medullar edema and hydromyelia. An emergency laminectomy was performed with evacuation of a well organized hematoma. There was a partial recuperation of the neurologic symptoms. Based on the scarce literature which only concerns seven case reports, SSEH is a rare cause of spinal compression in infancy. The presentation is often not specific and neurological symptoms are often lacking in the beginning. However early diagnosis with MRI and prompt neurosurgical intervention are important to improve outcome.
authors.affiliation: Department of Neurology-Pediatric Neurology, Antwerp University Hospital (UZA), University of Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium; Department of Pediatrics, Antwerp University Hospital, University of Antwerp, Belgium.
authors.forename: An-Sofie
authors.initials: AS
authors.lastname: Schoonjans
authors.forename: Jozef
authors.initials: J
authors.lastname: De Dooy
authors.forename: Sandra
authors.initials: S
authors.lastname: Kenis
authors.forename: Tomas
authors.initials: T
authors.lastname: Menovsky
authors.forename: Stijn
authors.initials: S
authors.lastname: Verhulst
authors.forename: Johan
authors.initials: J
authors.lastname: Hellinckx
authors.forename: Ingrid
authors.initials: I
authors.lastname: Van Ingelghem
authors.forename: Paul M
authors.initials: PM
authors.lastname: Parizel
authors.forename: Philippe G
authors.initials: PG
authors.lastname: Jorens
authors.forename: Berten
authors.initials: B
authors.lastname: Ceulemans
mesh_terms: D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male
keywords: Child; Infancy; Pediatric; Spontaneous spinal epidural hematoma