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Case Reports
. 2011 Jul 27:11:10.
doi: 10.1186/1471-227X-11-10.

Complete motor recovery after acute paraparesis caused by spontaneous spinal epidural hematoma: case report

Leandro U Taniguchi  1 , Felix H Pahl, José E D Lúcio, Roger S Brock, Marcos Q T Gomes, Tarso Adoni, Victor C C Fiorini, Rodrigo C Carvalho, Eli F Evaristo, Eduardo G Mutarelli, Guilherme Schettino
Affiliations
Case Reports

Complete motor recovery after acute paraparesis caused by spontaneous spinal epidural hematoma: case report

Leandro U Taniguchi et al. BMC Emerg Med. .

Abstract

Background: Spontaneous spinal epidural hematoma is a relatively rare but potentially disabling disease. Prompt timely surgical management may promote recovery even in severe cases.

Case presentation: We report a 34-year-old man with a 2-hour history of sudden severe back pain, followed by weakness and numbness over the bilateral lower limbs, progressing to intense paraparesis and anesthesia. A spinal magnetic resonance imaging scan was performed and revealed an anterior epidural hematoma of the thoracic spine. He underwent an emergency decompression laminectomy of the thoracic spine and hematoma evacuation. Just after surgery, his lower extremity movements improved. After 1 week, there was no residual weakness and ambulation without assistance was resumed, with residual paresthesia on the plantar face of both feet. After 5 months, no residual symptoms persisted.

Conclusions: The diagnosis of spontaneous spinal epidural hematoma must be kept in mind in cases of sudden back pain with symptoms of spinal cord compression. Early recognition, accurate diagnosis and prompt surgical treatment may result in significant improvement even in severe cases.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging of the thoracic spine. A, Sagittal T1-weighted imaging revealed an isointense anterior epidural mass extending from T3-T4 to T8-T9 (white arrows at the extremities of the mass), which compressed the spinal cord posteriorly, especially at the T5-T6 level. B, Sagittal T2-weighted imaging was helpful for delineation of the mass (white arrows at the extremities of the mass), which showed hyperintensity in this scan. The length was the same as that visualized with T1-weighted imaging, but the severity of the spinal cord compression was better visualized. C, Axial T2-weighted imaging revealed the epidural mass (white arrow) located in the anterior aspect of the spinal canal, compressing the spinal cord and obliterating the liquoric space.
See this image and copyright information in PMC

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