Rapid Recovery of Spontaneous Spinal Epidural Hematoma without Surgical Treatment: A Case Reportand Literature Review.

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Rapid Recovery of Spontaneous Spinal Epidural Hematoma without Surgical Treatment: A Case Reportand Literature Review.

World Neurosurg. 2018 Apr 27;:

Authors: Baozhang S, Geng F, Wang J, Zhang Z, Du C

Abstract
BACKGROUND: Spontaneousspinal epidural hematoma (SSEH) is a relatively uncommon yet potentially disabling neurological emergency.The classical presentation includes a severe acute attack, sometimes radiating pain at the back,interscapular, or neckareas, followed by neurological deficits. The main treatment is surgical,and self-healing cases are rare.
CASE DESCRIPTION: A 17-year-old female was admitted to the department of neurosurgery with neck pain, myasthenia of the limbs, and difficulty moving. Mild neck pain had developed 1weekprior with no obvious predisposing causes.She had suddenly suffered severe neck pain during normal walking and developedrapid paralysis of her limbs. There was no recent history of trauma, infection, or drug administration. Magnetic resonance imaging(MRI) performed 1 hour after the onset oflimb paralysis demonstrated a large spinal epidural hematoma that extended from C4 to C6.However, 9 hours after the initial onset of severe neck pain, her symptomscompletely ceased. An MRI demonstrated that the SSEH had nearly dissipated.
CONCLUSIONS: Most cases of SSEH with spontaneous resolutionare located on the upper thoracic and cervical spine.Surgery is the standard of care for these patients, but can occasionally be deferred if the patient demonstrates significant rapid improvement.

PMID: 29709757 [PubMed - as supplied by publisher]

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