Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Filters applied. Clear all
Case Reports
. 2017 Nov;96(44):e8473.
doi: 10.1097/MD.0000000000008473.

Spontaneous Spinal Epidural Hematomas: One Case Report and Rehabilitation Outcome

Affiliations
Free PMC article
Case Reports

Spontaneous Spinal Epidural Hematomas: One Case Report and Rehabilitation Outcome

Hang Xian et al. Medicine (Baltimore). .
Free PMC article

Abstract

Rationale: Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but potentially disabling disease, and the classical presentation of it includes an acute onset of severe, sometimes radiating back or neck pain, followed by signs and symptoms of rapidly evolving nerve root or spinal cord compression.

Patient concerns: Here, we report a 26-year-old female patient presented with weakness in bilateral lower extremities, progressing to intense paraplegia and anesthesia without recent medical history of trauma, infection, surgery, or drug use.

Diagnosis: A magnetic resonance imaging (MRI) scan of spinal cord was planned and a posterior epidural hematoma of the thoracic spine was observed.

Interventions: A posterior decompression and hematoma evacuation was performed after diagnosis immediately. Early rehabilitation program of the specific kind spinal cord injury was formulated and implemented.

Outcomes: The patient finally can handle basic living activities, such as completing wheelchair locomotion, transferring from bed to wheelchair independently after 3 months of rehabilitation.

Lessons: SSEH is a rarely occurring case in emergency. Acute chest pain and paraplegia could be the initial presentation of acute spinal epidural hemorrhage, but the diagnosis of patient without classical manifestations is still a challenge for doctors. Early diagnosis, prompt decompression, and individualized rehabilitation program can improve the prognosis and outcome.

Conflict of interest statement

The authors report no funding and conflicts of interest.

Figures

Figure 1
Figure 1
Spinal cord MRI of this case. (A) Shows the location of the hematoma which is a posterior epidural hematoma from T4-T7 level with spinal cord compression. (B) The mass had isointensity to the spinal cord on T1-weighted sagittal scanning images. (C) The mass had hyperintensity to the spinal cord on T2-weighted sagittal scanning images. (D) The mass had isointensity to the spinal cord on T1-weighted coronal scanning images. (E) The mass had hyperintensity to the spinal cord on T2-weighted coronal scanning images.

Similar articles

See all similar articles

Cited by 2 articles

References

    1. Aycan A, Ozdemir S, Arslan H, et al. Idiopathic thoracic spontaneous spinal epidural hematoma. Case Rep Surg 2016;2016:15430708. - PMC - PubMed
    1. Holtås S, Heiling M, Lönntoft M. Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation. Radiology 1996;199:409–13. - PubMed
    1. Bakker NA, Veeger NJ, Vergeer RA, et al. Prognosis after spinal cord and cauda compression in spontaneous spinal epidural hematomas. Neurology 2015;84:1894–903. - PubMed
    1. Hussenbocus SM, Wilby MJ, Cain C, et al. Spontaneous spinal epidural hematoma: a case report and literature review. J Emerg Med 2012;42:e31–4. - PubMed
    1. Taniguchi LU, Pahl FH, Lúcio JE, et al. Complete motor recovery after acute paraparesis caused by spontaneous spinal epidural hematoma: case report. BMC Emerg Med 2011;11:10. - PMC - PubMed

Publication types

Feedback