Delayed traumatic spinal epidural hematoma with spontaneous resolution of symptoms

The Journal of Emergency Medicine
Peter J CuencaAllister Stone

Abstract

Post-traumatic spinal epidural hematomas are uncommon, usually requiring emergent neurosurgical evacuation. We present a symptomatic delayed post-traumatic epidural hematoma of the T-spine that resolved within hours of administration of high dose steroids. A 22-year-old man presented 10 days after sustaining blunt trauma during a motor vehicle crash. He developed signs of acute cord compression with loss of sensation and motor function in bilateral lower extremities with priapism. Magnetic resonance imaging demonstrated a spinal epidural hematoma with 50% canal stenosis at the T4 level. His symptoms improved 1 h after the administration of high dose steroids. All symptoms resolved completely while the patient was in the Emergency Department and he was treated conservatively by Neurosurgery with no further sequelae. Thoracic spinal epidural hematoma is an uncommon condition that may present in delayed fashion after trauma with significant neurologic compromise. If neurologic symptoms improve with initial steroid therapy, patients with this condition may be treated conservatively with steroids and observation.

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Citations

May 26, 2005·Urology·S Alexis GordonYair Lotan
Sep 12, 2006·Journal of Neurosurgery. Spine·Eric M HornNicholas Theodore
Oct 8, 2014·Journal of Neurosciences in Rural Practice·Kanwaljeet GargBhawani Shankar Sharma
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Sep 9, 2008·The American Journal of Emergency Medicine·Ersin AksayOmer Kitis
Dec 13, 2006·The American Journal of Emergency Medicine·Cheng-Ta HsiehDa-Tong Ju
Oct 17, 2007·The Spine Journal : Official Journal of the North American Spine Society·Yat Wa Wong, K D K Luk
Dec 13, 2005·The American Journal of Emergency Medicine·Eduardo MiñambresAndrés González-Mandly
Sep 10, 2010·The American Journal of Emergency Medicine·Hsing-Lin LinWei-Che Lee
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Apr 30, 2016·Journal of Clinical Psychology·Mark M KnowlesAdrian Wells
Nov 4, 2008·The Journal of the American Academy of Orthopaedic Surgeons·Christopher A HeckWilliam J Richardson

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