Complete motor recovery after acute paraparesis caused by spontaneous spinal epidural hematoma: case report

BMC Emergency Medicine

Case Report

Leandro U Taniguchi¹  Victor CC Fiorini²  Guilherme Schettino²  Felix H Pahl²  Marcos QT Gomes³  Roger S Brock³  Eli F Evaristo³  Rodrigo C Carvalho³  Eduardo G Mutarelli³  Tarso Adoni³  José ED Lúcio³ 

[1] Discipline of Emergency Medicine, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar 255, sala 5023, São Paulo, Brazil;Hospital Sírio Libanês, Rua Dona Adma Jafet 91, São Paulo, Brazil;Hospital Sírio Libanês, Rua Dona Adma Jafet 91, São Paulo, Brazil;Hospital Sírio Libanês, Rua Dona Adma Jafet 91, São Paulo, Brazil;Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar 255, sala 5084, São Paulo, Brazil;

关键词: Thoracic Spine;    Spinal Cord Compression;    Epidural Hematoma;    Spinal Magnetic Resonance Imaging;    Severe Back Pain;   

DOI  :  10.1186/1471-227X-11-10

 received in 2010-12-30, accepted in 2011-07-27,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundSpontaneous spinal epidural hematoma is a relatively rare but potentially disabling disease. Prompt timely surgical management may promote recovery even in severe cases.Case presentationWe report a 34-year-old man with a 2-hour history of sudden severe back pain, followed by weakness and numbness over the bilateral lower limbs, progressing to intense paraparesis and anesthesia. A spinal magnetic resonance imaging scan was performed and revealed an anterior epidural hematoma of the thoracic spine. He underwent an emergency decompression laminectomy of the thoracic spine and hematoma evacuation. Just after surgery, his lower extremity movements improved. After 1 week, there was no residual weakness and ambulation without assistance was resumed, with residual paresthesia on the plantar face of both feet. After 5 months, no residual symptoms persisted.ConclusionsThe diagnosis of spontaneous spinal epidural hematoma must be kept in mind in cases of sudden back pain with symptoms of spinal cord compression. Early recognition, accurate diagnosis and prompt surgical treatment may result in significant improvement even in severe cases.

【 授权许可】

CC BY   
© Taniguchi et al; licensee BioMed Central Ltd. 2011