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Case Reports
. 2019 Jan-Mar;14(1):286-288.
doi: 10.4103/ajns.AJNS_333_17.

Spontaneous Cervical Epidural Hematoma with Stroke Manifestations

Mohammadreza Emamhadi  1 , Shervin Ghadarjani  2 , Babak Alijani  2 , Shahrokh Yousefzadeh-Chabok  3 , Hamid Behzadnia  2 , Amin Naseri  2 , Sasan Andalib  3
Affiliations
Case Reports

Spontaneous Cervical Epidural Hematoma with Stroke Manifestations

Mohammadreza Emamhadi et al. Asian J Neurosurg. 2019 Jan-Mar.

Abstract

Spontaneous cervical epidural hematoma (SCEH), which is a rare disease, is manifested as by a sudden quadriplegia or paraplegia and other neurological deficits. SCEH can compress the spinal cord resulting in its clinical manifestations. The reported etiological risk factors are anticoagulants, coagulopathies, vascular malformations, infections, and herniated discs. Here, we report a 77-year-old woman with a presenting chief complaint of left hemiparesis and a history of hypertension. The medical drugs in use were aspirin and antihypertensives. The initiating presentations were hemiparesis, in favor of ischemic stroke, so the patient admitted to neurology ward and received anticoagulant therapy with the initial diagnosis of stroke. Although clinical manifestations and examinations are important in these patients due to mimicking stroke picture, imaging evaluation is paramount for a definite diagnosis, which in our case showed a SCEH, who was suspected to have an ischemic stroke during the initial assessment because its initial demonstration mimicked ischemic stroke. This patient underwent laminectomy after 3 days and showed a clinical recovery the day after. Her muscle strength improved gradually, and neurological symptoms were diminished after physiotherapy.

Keywords: Laminectomy management; spontaneous cervical epidural hematoma; stroke symptoms.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
T1-weighted sagittal magnetic resonance images showing a mixed intensity acute hematoma compressing the spinal cord in epidural space at the C3-T1 levels
Figure 2
Figure 2
T2-weighted axial magnetic resonance images showing a mixed intensity acute hematoma compressing the spinal cord in epidural space at the C3-T1 levels
Figure 3
Figure 3
Axial computed tomography scan of cervical spine showing hyperdensity in epidural space
See this image and copyright information in PMC

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