Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Aug 6;2024(8):omae086.
doi: 10.1093/omcr/omae086. eCollection 2024 Aug.

Delayed presentation of traumatic cervical epidural hematoma: a case report and review of the pertinent literature

Taiki Isaji  1 , Tadato Yukiue  1 , Takayuki Amano  1
Affiliations
Case Reports

Delayed presentation of traumatic cervical epidural hematoma: a case report and review of the pertinent literature

Taiki Isaji et al. Oxf Med Case Reports. .

Abstract

A delayed presentation of traumatic spinal epidural hematoma (SEH) is a rare disease in which most patients are asymptomatic for days to weeks after the injury, followed by pain and then a neurological deficit. A 66-year-old woman who suffered a fractured right clavicle due to a bicycle accident 42 days previously, presented with left shoulder pain and left hemiplegia. The manual muscle test (MMT) scores of the left upper and lower limbs were all 1. Computed tomography and magnetic resonance imaging showed no cervical fracture but showed cervical epidural hematoma. She underwent surgery for the removal of the SEH. Her MMT score improved to 4 at 10 days after surgery. Even in cases with a delayed presentation, suspecting SEH can help clinicians make an early diagnosis. Additionally, the prompt surgical evacuation of the SEH can lead to favorable neurological outcomes in symptomatic cases.

Keywords: delayed presentation; spinal epidural hematoma; trauma.

PubMed Disclaimer

Conflict of interest statement

No conflicts of interest.

Figures

Figure 1
Figure 1
(A) T2-weighted Magnetic resonance imaging (MRI) showing an epidural hematoma at the C2/3 to C4 level. (B) Computed tomography (axial image) showing a hematoma predominantly on the left side at the C3 level (arrow).
Figure 2
Figure 2
(A and B) Two days after surgery, T2-weighted Magnetic resonance imaging (sagittal and axial images) show decompression of the spinal cord and intramedullary high signal intensity in the left half at the C3 level.
See this image and copyright information in PMC

References

    1. Vanichkulbodee A, Issaragrisil S, Inboriboon PC. Massage-induced spinal epidural hematoma presenting with delayed paraplegia. Am J Emerg Med 2019;37:797.e1–4. - PubMed
    1. Kang MS, Shin YH, Lee CD. et al. Delayed neurological deficits induced by an epidural hematoma associated with a thoracic osteoporotic compression fracture. Neurol Med Chir (Tokyo) 2012;52:633–6. - PubMed
    1. Cuenca PJ, Tulley EB, Devita D. et al. Delayed traumatic spinal epidural hematoma with spontaneous resolution of symptoms. J Emerg Med 2004;27:37–41. - PubMed
    1. Hsieh CT, Chiang YH, Tang CT. et al. Delayed traumatic thoracic spinal epidural hematoma: a case report and literature review. Am J Emerg Med 2007;25:69–71. - PubMed
    1. Dimou J, Jithoo R, Bush S. A patient with delayed traumatic cervical spinal epidural haematoma presenting with hemiparesis. J Clin Neurosci 2010;17:404–5. - PubMed

Publication types

LinkOut - more resources