Spontaneous Spinal Epidural Hematoma in a 12-Year-Old Child

Abstract

Spontaneous spinal epidural hematoma (SSEH) is uncommon, with an estimated incidence of one per million per year in the general population. Since SSEH was first described, only 29 cases have been reported in children. This condition is difficult to diagnose and needs immediate surgical intervention for hematoma evacuation and cord decompression to obtain optimal functional and neurological outcomes. The presentation in children might be atypical. We present a case that was managed surgically and yielded full recovery.

Keywords: cervical spine; children; epidural hematoma; spinal cord injury; trauma.

Figure 1. Sagittal MR images in T1WI & T2WI

A heterogenous fusiform long left posterolateral epidural lesion that appears generally isointense on T1W, and heterogeneously high on T2W images with focal areas of altered signal within. No remarkable contrast enhancement may could be seen. Findings are in keeping with epidural hematoma.

Figure 2. Axial MR images at same level in T2WI & T1 post contrast enhancement

A heterogenous fusiform left posterolateral epidural lesion that appears heterogeneously high on T2W images with no remarkable contrast enhancement in the post gadolinium T1 study. Findings are in keeping with epidural hematoma.