Stroke-like manifestation of a spontaneous spinal epidural hematoma with spontaneous resolution: a case report

International Journal of Emergency Medicine

Case Report

Swee Min, Kathleen Khoo¹  Xue Bi, May Na¹ 

[1]Emergency Department, Khoo Teck Puat Hospital, National Healthcare Group, 90 Yishun Central, 768828, Singapore, Singapore

关键词: Hematoma;    Epidural;    Spinal;    Stroke;    Spine;    Paresis;    Emergency Service;    Hospital;   

DOI  :  10.1186/s12245-023-00478-0

 received in 2022-11-30, accepted in 2023-01-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThis case report presents the case of a man with no known coagulopathy or preceding trauma, who spontaneously developed a spinal epidural hematoma (SEH). This is an uncommon condition which can have variable presentations including hemiparesis mimicking stroke, resulting in the potential for misdiagnosis and inappropriate treatment.Case presentationA 28-year-old Chinese male with no past medical history presented with sudden onset neck pain associated with bilateral upper limbs and right lower limb subjective numbness but intact motor function. He was discharged after adequate pain relief but re-attended the emergency department with right hemiparesis. A magnetic resonance imaging of his spine revealed an acute cervical spinal epidural hematoma at C5 and C6. While admitted, he had spontaneous improvement of his neurological function and was eventually managed conservatively.ConclusionsSEH, although uncommon, can be a mimic of stroke and it is important to avoid misdiagnosis as it is a time critical diagnosis, and administration of thrombolysis or antiplatelets can lead to unfavourable outcomes. Having a high clinical suspicion can help to guide us in the choice of imaging and interpretation of subtle signs to reach the correct diagnosis in a timely manner. Further research is required to better understand the factors that would favour a conservative approach as opposed to surgical treatment.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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