Neurológia pre prax 1/2012

Spontaneous epidural hematoma in the cervical spine

Spontaneous spinal epidural hematoma is a rare clinical entity. It represents less than 1 % of all lesions located in the epidural space of the spinal canal. Our case report describes 63-year-old patient admitted for a suddenly incurred intense neck pain and paresthesia in the right upper limb with progression to severe right spasic hemiparesis. The magnetic resonance showed epidurally located mass in the area C3–4, dorsal to the spinal cord with its significant compression. We urgently evacuated the expansion. No possible cause of hematoma was discovered during the surgery and the histopathological exam disclosed only parts of hematoma. Four years after the surgery the patient is self sufficient with slight spastic monoparesis of the right lower limb. The magnetic resonance shows appropriate width of the spinal canal in the primarily affected area.

Keywords: spontaneous spinal epidural hematoma, cervical spine, myelopathy, spinal cord compression.