Résumé
Spontaneous cervical epidural hematoma (SCEDH) is a rare disease, but can cause severe neurologic impairment. We report a case of a 68-year-old female who presented with sudden onset, posterior neck pain, right shoulder pain, and progressive right hemiparesis mimicking stroke with no trauma history. Initial brain CT and diffusion MRI performed to rule out brain lesion did not show any positive findings. Laboratory examination presented only severe thrombocytopenia (45,000/mm3). Subsequent cervical MRI revealed a cervical epidural mass lesion. We confirmed that it was pure hematoma through C5 unilateral total laminectomy and C6 partial hemilaminectomy. She achieved complete neurologic recovery with active rehabilitation. Early surgical decompression for SCEDH with neurologic impairment should be recommended for better outcome.
Sujets)
Sujet âgé , Femelle , Humains , Encéphale , Décompression chirurgicale , Imagerie par résonance magnétique de diffusion , Hématome , Laminectomie , Cirrhose du foie , Cervicalgie , Parésie , Maladies rares , Scapulalgie , Accident vasculaire cérébral , ThrombopénieRésumé
Spontaneous cervical epidural hematoma (SCEH) is a rare clinical entity and has a varied etiology. Urgent surgical decompression should be done to prevent serious permanent neurologic deficits. We describe a 59-year-old female who presented with Brown-Sequard syndrome due to spontaneous cervical epidural hematoma. Initially, she was misdiagnosed as cerebrovascular accident. Cervical magnetic resonance imaging revealed epidural hematoma to the right of the spinal cord extending from C3 to C6. She later underwent surgical evacuation and had complete restoration of neurologic function. The outcome in SCEH is essentially determined by the time taken from onset of the symptom to operation. Therefore, early and precise diagnosis such as careful history taking and MRI evaluation is mandatory.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Syndrome de Brown-Séquard , Décompression chirurgicale , Hématome , Imagerie par résonance magnétique , Manifestations neurologiques , Moelle spinale , Accident vasculaire cérébralRésumé
Spontaneous cervical epidural hematoma is an infrequent entity that usually requires emergency decompression on account of impending neurologic deficit. We present a case of a 36-year-old man who visited our emergency room complainng of severe neck pain with progressive weakness of both upper extrmities. On cervical MRI, fusiform epidural hematoma was found extending from the fifth to the seventh cervical vertebrae. Emergency surgical evacuation was performed. The patient was fully recovered and discharged uneventfully.