Acute spontaneous epidural hematoma of cervical spine presenting as quadriparesis in a young patient: a case report

Abstract

Introduction: Spontaneous spinal epidural hematoma (SSEH) is a relatively uncommon pathology of the spine. The incidence of SSEH is approximately 0.1 – 1 per 100,000 individuals. SSEH can cause acute spinal cord compression and rapid onset of neurologic deficits. Although rare, SSEH must be considered in the differential diagnosis of patients presenting with sudden onset of neurologic symptoms without a history of trauma.Case presentation: We report a case of a 19-year-old female patient who presented with sudden onset of weakness of all four limbs with pain in the upper cervical region. She has no history of trauma. Magnetic Resonance Imaging (MRI) of the spine was done, which showed an epidural mass in the cervical region, causing severe cord compression. Emergency cervical laminectomy and evacuation of epidural hematoma has was done with excellent post-operative recovery.Conclusion: Spontaneous spinal epidural hematoma is a relatively rare entity of the spine. The signs and symptoms of this rare condition are non-specific. In patients presenting with a sudden onset of neurologic deficits, the condition should be one of the differential diagnoses. MRI is the investigation of choice in patients suspected to have SSEH. Early surgical intervention results in a better outcome. The level of preoperative neurologic deficit, the severity of the condition, and operative interval are important factors affecting the postoperative outcome.Keywords: cervical spine, laminectomy, spontaneous spinal epidural hematoma