Share this Article
Mahmud NA, Singh DR, Wong SB, Peh WC
Correspondence: Prof Wilfred CG Peh, wilfred.peh@gmail.com
ABSTRACT
Spontaneous spinal epidural haematoma is a rarely encountered cause of back pain. It often leads to cauda equina syndrome, necessitating emergency spinal surgery. We report the case of a 19-year-old Chinese man who presented with pain in the lower back, which started after he had carried some heavy boxes. He denied a history of fall or trauma. Magnetic resonance (MR) imaging showed a hyperintense biconvex-shaped lesion in the posterior epidural space on both T1- and T2-weighted sequences, diagnostic of a spinal epidural haematoma. The patient, who was admitted and managed conservatively, had gradual resolution of his pain. No neurological deficit was detected on discharge or on follow-up. Repeat MR imaging showed total resolution of the lumbar spinal epidural haematoma. The clinical characteristics, MR imaging features, diagnosis and management of spontaneous spinal epidural haematoma are discussed.
Singapore Med J 2013; 54(12): 666-672; http://dx.doi.org/10.11622/smedj.2013239
REFERENCES
| 1. Fukui MB, Swarnkar AS, Williams RL. Acute spontaneous spinal epidural hematomas. AJNR AM J Neuroradiol 1999; 20:1365-72. | ||||
| 2. Hsieh CT, Chiang YH, Tang CT, Sun JM, Ju DT. Delayed traumatic thoracic spinal epidural hematoma: a case report and literature review. Am J Emerg Med 2007; 25:69-71. http://dx.doi.org/10.1016/j.ajem.2006.05.033 |
||||
| 3. Foo D, Rossier AB. Post-traumatic spinal epidural hematoma. Neurosurgery 1982; 11(1 Pt 1):25-32. http://dx.doi.org/10.1227/00006123-198207010-00006 |
||||
| 4. Dinsmore AJ, Leonard RB, Manthey D. Spontaneous spinal epidural hematoma: a case report. J Emer Med 2005; 28:423-6. http://dx.doi.org/10.1016/j.jemermed.2004.11.023 |
||||
| 5. Chen CJ, Ro LS. Central gadolinium enhancement of an acute spontaneous spinal epidural haematoma. Neuroradiology 1996; 38 Suppl 1:S114-6. http://dx.doi.org/10.1007/BF02278136 |
||||
| 6. Jamjoon ZA. Acute spontaneous spinal epidural hematoma: the influence of magnetic resonance imaging on diagnosis and treatment. Surg Neurol 1996; 46:345-9. http://dx.doi.org/10.1016/S0090-3019(96)00149-8 |
||||
| 7. van Heesewijk JP, Casparie JW. Acute spontaneous spinal epidural hematoma in a child. Eur Radiol 2000; 10:1874-6. http://dx.doi.org/10.1007/s003300000494 |
||||
| 8. Ravi D, Dwarakanath S, Satish R, Gopal S, Venkataramana NK. Spontaneous spinal extradural hematomas. J Clin Neurosci 2006; 13:269-72. http://dx.doi.org/10.1016/j.jocn.2005.03.029 |
||||
| 9. Chang FC, Lirng JF, Luo CB, et al. Evaluation of clinical and MR findings for the prognosis of spinal epidural haematomas. Clin Radiol 2005; 60:762-70. http://dx.doi.org/10.1016/j.crad.2004.12.008 |
||||
| 10. Karadeli E, Ulu EMK, Ozdemir O, Calisaneller T. Contrast enhancement of acute spinal epidural haematoma and its potential of mimicking a tumor: case report and review of literature. Eur J Radiol Extra 2008; 65:43-6. http://dx.doi.org/10.1016/j.ejrex.2007.12.003 |
||||
| 11. Braun P, Kazmi K, Nogués-Meléndez P, Mas-Estellés F, Aparici-Robles F. MRI findings in spinal subdural and epidural hematomas. Eur J Radiol 2007; 64:119-25. http://dx.doi.org/10.1016/j.ejrad.2007.02.014 |
||||
| 12. Kirsch EC, Khangure MS, Holthouse D, McAuliffe W. Acute spontaneous spinal subdural hematoma: MRI features. Neuroradiology 2000; 42:586-90. http://dx.doi.org/10.1007/s002340000331 |
||||
| 13. Nawashiro H, Higo R. Contrast enhancement of a hyperacute spontaneous spinal epidural hematoma. AJNR Am J Neuroradiol 2001; 22:1445. | ||||
| 14. Holtås S, Heiling M, Lönntoft M. Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation. Radiology 1996; 199:409-13. | ||||
| 15. Kebaish KM, Awad JN. Spinal epidural hematoma causing acute cauda equina syndrome. Neurosurg Focus 2004; 16:e1. http://dx.doi.org/10.3171/foc.2004.16.6.1 |
||||
| 16. Nayak N, Baldawa S, Diyora B, Sharma A. Delayed recovery of paraplegia following surgical evacuation of spontaneous cervicothoracic epidural hematoma. Childs Nerv Syst 2011; 27:2031-2. http://dx.doi.org/10.1007/s00381-011-1591-x |
||||