Abstract
Spontaneous spinal epidural hematomas are rare and potentially disabling neurological emergencies. Its lead to devastating neurologic outcomes and most patient does not recover completely. The clinical presentation is diverse and includes a severe acute attack, radiating pain at the back, interscapular, or neurological deficits. We report a case of a young woman, 24-year-old, that was admitted to our department for sudden non-traumatic cervical spinal cord compression syndrome (Type A of the American Spinal Cord Injury Association “ASIA A”) including intense cervical back pain, sensory loss, and tetraplegia. Her past medical history was unremarkable. The MRI confirmed a cervical mass responsible for the spinal cord compression and the emergent surgical intervention allow us to evacuate acute C3-C7 hematoma. The patient never recovers from the neurologic deficit despite the emergent management of her case followed by functional musculoskeletal rehabilitation for two years.
Highlights
Spontaneous spinal epidural hematomas are known as the idiopathic accumulation of blood within the spinal canal’s epidural space, causing symptoms varying from general back pain to complete paraplegia [1]
Fifty percent of spontaneous spinal epidural hematoma patients do not fully recover and 30% of patients who presented with ASIA A classification did not improve with surgery [3]
We present a case of a 24-year-old woman who never recovers from her ASIA A spontaneous cervical epidural hematoma in spite of rapid surgical evacuation in an emergency setting, 48 hours of the tetraplegia onset
Summary
Spontaneous spinal epidural hematomas are known as the idiopathic accumulation of blood within the spinal canal’s epidural space, causing symptoms varying from general back pain to complete paraplegia [1] It is a very rare cause of acute spinal cord compression and is estimated to occur on yearly basis in approximately 0.1% of 100,000 individuals [2]. We present a case of a 24-year-old woman who never recovers from her ASIA A spontaneous cervical epidural hematoma in spite of rapid surgical evacuation in an emergency setting, 48 hours of the tetraplegia onset. Patient under general anesthesia and in a supine position, we did laminectomy at C4-C5-C6 and got directly on a bunch of clotted blood in direct contact with dura sheath This large extradural hematoma was completely evacuated. A subsequent search for a hemorrhagic defect proved was unsuccessful
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