PMID: 8949971Oct 1, 1996Paper

Cervical spinal epidural haematoma: the double jeopardy

Annals of Medicine
G PhookanK R Kuhlengel

Abstract

Spontaneous spinal epidural haematoma is an unusual but well recognized cause of compressive myelopathy or cauda equina syndrome. Radicular pain is one of the earliest symptoms and a hallmark of spontaneous spinal epidural haematoma, as in the case of cervical spondylosis and disc prolapse. Should an epidural haematoma be located in the cervical spine, the resultant cervical radicular pain may sometimes be erroneously attributed to a cardiac cause, especially in the setting of pre-existing cardiac disease. The error in diagnosis can lead to another pitfall, the addition of heparin. If the etiology of the pain is a cervical epidural haematoma this can have grave consequences. Moreover, patients with cardiac ischemia who are treated with anticoagulants may rarely develop a cervical epidural haematoma. The resulting radicular pain can overlap with cardiac pain and escape recognition. Symptoms of neck and upper extremity pain with bilateral signs of myelopathy with a sensory level should lead to a suspicion of acute cervical cord compression. The addition of heparin can only compound the disastrous consequence of a rapidly expanding spinal epidural haematoma. The following cases illustrate this diagnostic and therapeutic conundrum.

References

Feb 1, 1979·Archives of Internal Medicine·A Silverstein
Mar 1, 1976·Neurology·R C SenelickG H Cohen
May 16, 1975·Deutsche medizinische Wochenschrift·H D Langohr
Mar 1, 1992·Journal of Spinal Disorders·S Mirkovic, M Melany
Jan 1, 1990·Clinical Neurology and Neurosurgery·N Di LorenzoA Fortuna
Jan 1, 1988·Clinical Neurology and Neurosurgery·L CalliauwL Vannerem
Sep 1, 1987·Journal of Computer Assisted Tomography·W E RothfusR L Sherman
May 1, 1972·The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine·B L Pear
Jun 17, 1971·The New England Journal of Medicine·S I HarikD J Reis
Feb 26, 1966·British Medical Journal·I JacobsonN M Dott
Mar 1, 1967·Journal of Neurosurgery·J W MarkhamG E Stahlman
May 1, 1984·Surgical Neurology·G CostabileC Probst
Jul 1, 1984·Journal of Neurosurgery·R M Beatty, K R Winston
Feb 1, 1962·Journal of Neurosurgery·H M CUBE
Apr 1, 1963·Journal of Neurology, Neurosurgery, and Psychiatry·B H DAWSON
Apr 1, 1964·Annals of Surgery·R E STRAIN

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Citations

Mar 2, 2005·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·Hayley A Hamilton
Dec 24, 2005·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Chun-Fu HsiehAntonio Leo Te
Mar 14, 2007·Emergency Medicine Journal : EMJ·Adel Helmy, Greg Mellor
Jun 16, 2010·The Spine Journal : Official Journal of the North American Spine Society·M SubbiahS Rajasekaran
Jan 16, 2010·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·James DimouSteven Bush
Feb 15, 2014·Journal of Central Nervous System Disease·Tetsu AkimotoDaisuke Nagata
Jul 4, 2002·European Journal of Anaesthesiology·A Tyagi, A Bhattacharya
Jul 18, 2009·Journal of Korean Neurosurgical Society·Seung-Hun OhOk-Joon Kim

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