Transient hemiparesis caused by spontaneous cervical epidural hematoma

Acta neurologica Belgica
Robin LemmensBart Depreitere

Abstract

Spontaneous cervical epidural hematoma (SCEH) is rare and can result in various clinical phenotypes. Transient focal neurological symptoms, which have not yet been reported on, can result in overlooking this differential diagnosis in patients presenting with passing neurological deficits and assuming the diagnosis of a transient ischemic attack. Therefore, a thorough documentation of patient history is of importance, since this can reveal symptoms suggestive of a different etiology. Here, we present a case of a 66-year-old female who was admitted with a hemiparesis without cortical or cranial neurological abnormalities. When asked for preceding symptoms like headache or neck ache she mentioned interscapular pain. Imaging of the cervical spine showed an epidural hematoma. Symptoms resolved spontaneously over 24 h without surgical intervention. Our case illustrates the variation in the clinical presentation of SCEH which can result in transient symptoms, even without surgical intervention. Therefore, in patients with transient focal neurological deficits this diagnosis should be included in the differential, particularly when cortical and cranial signs are lacking.

References

Dec 24, 2005·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Chun-Fu HsiehAntonio Leo Te
Nov 14, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Che-Chuan WangJinn-Rung Kuo
Jun 16, 2010·The Spine Journal : Official Journal of the North American Spine Society·M SubbiahS Rajasekaran
Jun 7, 2011·Journal of Neuroradiology. Journal De Neuroradiologie·K C BaileyJ S Huff
Sep 17, 2011·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Weiying ZhongSiqing Huang

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Citations

Feb 15, 2014·Journal of Central Nervous System Disease·Tetsu AkimotoDaisuke Nagata
May 19, 2018·Korean Journal of Neurotrauma·Min Chan Kim, Seok Won Kim

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