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Case Reports
. 2019 Dec 3;12(12):e232055.
doi: 10.1136/bcr-2019-232055.

Post-traumatic thoracolumbar spinal epidural haematoma in a child: a rare clinical entity

Saurabh Vashisht  1 , Ashish Dagar  2 , Vishal Kumar  2 , Sarvdeep Singh Dhatt  2
Affiliations
Case Reports

Post-traumatic thoracolumbar spinal epidural haematoma in a child: a rare clinical entity

Saurabh Vashisht et al. BMJ Case Rep. .

Abstract

Post-traumatic spinal epidural haematoma (SEH) is a rare clinical entity in children. We are reporting the case of an 8-year-old child who presented with thoracolumbar SEH with neurological deficit. MRI confirmed SEH without bony disruption. Emergency evacuation of haematoma was done. There was an improvement in neurological status after removal of haematoma. Diagnosis of this rare condition is tricky in children owing to variable presenting symptoms, especially in an early stage with subtle neurological changes. There should be high clinical suspicion in children with atypical symptoms, and MRI should be done to confirm the diagnosis. Patients with acute neurological deficit should undergo urgent operative decompression. Conservative treatment has a limited role. Patients may be considered for non-operative management if they have medical contraindications, coagulation dysfunction or a small SEH without neurological deficit. These patients require serial MRI monitoring.

Keywords: back pain; neurological injury; orthopaedic and trauma surgery; paediatrics; spinal cord.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Axial T1-weighted (A) and T2-weighted (B) MRI showing the hyperintense collection in the epidural space and pushing the cord towards the right side and anteriorly.
Figure 2
Figure 2
Sagittal T1-weighted MRI (A) shows extradural haematoma (hyperintense signal) at the level of D10 to L1 and compression of the spinal cord. Sagittal contrast-enhanced MRI (B) showing peripheral contrast enhancement.
Figure 3
Figure 3
Axial post-contrast T1-weighted MRI showing peripheral enhancement.
Figure 4
Figure 4
Photograph showing the laminectomy performed at level D11 and D12 for the evacuation of an epidural haematoma.
See this image and copyright information in PMC

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