Spontaneous spinal extradural hematoma during pregnancy.

Abstract

Spontaneous spinal hematomas are rare in pregnancy, and only two cases have previously been described. This report reviews other similar cases and discusses the aetiology and management of this condition in relation to pregnancy. A 26-year-old primigravida presented at 35 weeks of gestation with a history of sudden onset of back pain and weakness with loss of sensation of her legs. On examination there was tenderness over the seventh thoracic vertebra with loss of sensation below the level of the T7 dermatome and reduced power in both lower limbs. Magnetic resonance imaging demonstrated an anterior extradural lesion in the mid-thoracic region of the spinal cord. An elective cesarean section was performed followed by a costotransversectomy and removal of an extradural hematoma. The patient's neurological function subsequently improved. Acute spontaneous spinal extradural hematoma occurring during pregnancy can be associated with successful outcome following prompt diagnosis and surgical treatment.