Korean J Neurotrauma.  2019 Oct;15(2):209-213. 10.13004/kjnt.2019.15.e26.

Traumatic Cervical Epidural Hematoma without Osseous Fracture Presenting as Hemiparesis

• Lee HS
• Ju CI
• Kim SW

• KMID: 2461130
• DOI: http://doi.org/10.13004/kjnt.2019.15.e26

Abstract

Traumatic cervical epidural hematoma (EDH) with no osseous fracture or underlying hematological abnormalities is a rare disorder that sometimes requires emergent surgical decompressive therapy. A 47-year-old woman was admitted to our emergency room due to severe neck pain and rapid onset hemiparesis after a car accident. Plain cervical radiographs and computed tomography scan did not reveal any abnormality. However, magnetic resonance imaging (MRI) revealed a large posterior EDH compressing the spinal cord extensively from C3 to C5. Emergent hematoma removal was performed following laminectomy, and subsequently the patient showed substantial clinical improvement. Complete removal of the hematoma was confirmed by MRI at 10 days after surgery. Here, the authors present a discussion of the etiology, pathogenesis, and prognosis of this rare pathologic entity.

Keyword

Cervical spine; Epidural hematoma; Fracture

MeSH Terms

Emergency Service, Hospital
Female
Hematoma*
Humans
Laminectomy
Magnetic Resonance Imaging
Middle Aged
Neck Pain
Paresis*
Prognosis
Spinal Cord

Figure

• 

  FIGURE 1 T2 weighted sagittal and axial images show a dorsolateral epidural hematoma extending from C3 to C5 presenting as high signal.

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  FIGURE 2 Intraoperative finding of epidural hematoma (star).

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  FIGURE 3 Follow-up magnetic resonance images obtained 10 days after surgery reveal complete removal of hematoma.

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