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Case Reports
. 2022 Jan:90:106719.
doi: 10.1016/j.ijscr.2021.106719. Epub 2021 Dec 23.

A case of spontaneous thoracolumbar epidural hematoma in Covid-19 pneumonia

Özkaya Zübeyde  1 , Kurtuluş Adem  2 , Dinç Samet  1
Affiliations
Case Reports

A case of spontaneous thoracolumbar epidural hematoma in Covid-19 pneumonia

Özkaya Zübeyde et al. Int J Surg Case Rep. 2022 Jan.

Abstract

Introduction and importance: Covid-19 is an important disease that still occupies our agenda, and as time passes, we have been observing its extrapulmonary manifestations. In this study, we presented a case of spontaneous thoracolumbar epidural hematoma, which we could not attribute to any cause other than Covid-19.

Case presentation: We presented a 55-year-old female patient whose etiology could not be found to be compatible with the literature. In the formation of this disease, we did not have any positive findings except for Covid-19, which she had 20 days ago. The patient had no history of anticoagulant or antiaggregant drug use. He had no history of trauma and no signs. Hematological tests were normal. We evacuated the hematoma in the T12-L1 vertebral canal after laminectomy and the pathology result was compatible with hematoma.

Clinical discussion: Although spontaneous spinal epidural hematoma is rare, many factors are blamed for its etiology. Many extrapulmonary complications of Covid-19 stand out in the literature. The fact that the patient had Covid-19 did not affect the neurosurgical approach, but we think that it is useful to examine the complaints of patients with Covid-19 more systematically.

Conclusion: Spontaneous spinal epidural hematomas are rare. Making the correct diagnosis often takes time and is difficult. Decompression surgery is at the forefront as a treatment option. However, conservative treatment can be performed in suitable patients. As we saw in this case, we should consider Covid-19 among the etiological causes.

Keywords: Covid-19; Spinal Canal; Spinal epidural hematoma.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Thoracic computed tomography with typical Covid-19 findings.
Fig. 2
Fig. 2
Pre-operative axial MRI image of the mass lesion.
Fig. 3
Fig. 3
Pre-operative sagittal MRI image of the mass lesion.
Fig. 4
Fig. 4
Intra-operative view of epidural hematoma.
See this image and copyright information in PMC

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