J Korean Soc Emerg Med.  2014 Jun;25(3):340-343.

Cervical Spine Epidural Hematoma Disguised as Acute Ischemic Stroke: A Case Report

• Cho S
• Choi SW
• Kang TK
• Kim HJ
• Oh SC
• Ryu SY

Abstract

Cervical spine epidural hematoma is a rare disease, which can sometimes be misdiagnosed as acute ischemic stroke when a patient shows hemiparesis. A 68-year-old woman visited the emergency department with right side motor weakness without signs of facial palsy or cranial nerve deficit. She also complained of accompanying neck pain. Acute ischemic stroke was suspected initially and a non-contrast computed tomography of the brain was taken, which showed no cerebral hemorrhage. Brain and cervical spine magnetic resonance imaging (MRI) was performed for further evaluation. No evidence of cerebral infarction. However, an epidural hematoma was detected on cervical spine MRI. The patient was consulted to the neurosurgery department and decompressive laminectomy and hematoma evacuation was performed. Emergency physicians should consider cervical spine epidural hematoma in cases of sudden onset hemiparesis with accompanying neck pain.

Keyword

Spinal epidural hematoma; Magnetic resonance Imaging; Cerebrovascular disorders

MeSH Terms

Aged
Brain
Cerebral Hemorrhage
Cerebral Infarction
Cerebrovascular Disorders
Cranial Nerves
Emergencies
Emergency Service, Hospital
Facial Paralysis
Female
Hematoma*
Hematoma, Epidural, Spinal
Humans
Laminectomy
Magnetic Resonance Imaging
Neck Pain
Neurosurgery
Paresis
Rare Diseases
Spine*
Stroke*