Acute Spontaneous Cervical Spinal Epidural Hematoma with Spontaneous Resolution: A Case Report

ABSTRACT

STUDY DESIGN: This is a case report. OBJECTIVES: We wanted to report on the spontaneous dissolution of acute spontaneous epidural hematoma of the cervical spine and the effectiveness of conservative treatments, in the cases where the symptoms related to spontaneous epidural hematoma improve by themselves in a short period. SUMMARY OF LITERATURE REVIEW: Cases of acute spontaneous epidural hematoma of the cervical spine are rarely reported; surgical decompression procedures have been performed in most of the cases as treatment. However, there are some reported cases of hematoma dissolving spontaneously after a certain period of conservative treatment. MATERIALS AND METHODS: A 29 year-old female, who had no history of recent trauma, appealed neck pain with radiating pain in her upper right extremity due to acute epidural hematoma of the cervical spine which was diagnosed with MRI. The neck pain and radiating pain showed early recovery and gradual improvement during a period of the following 7 days after occurrence. MRI studies were done after 3 days, 7days, and 1 month from the day of occurrence of the symptoms. RESULTS: In comparing MRI studies there were significant decreases in the sizes of hematoma, which implied spontaneous dissolution. Almost all the symptoms related to acute spontaneous epidural hematoma vanished after a 1-month period of conservative treatment. CONCLUSIONS: Decompressive surgical procedure may not be necessary, if the symptoms related to spontaneous epidural hematoma improve by themselves in short period of conservative treatment.