[Cervical extradural hematoma revealing hemophilia]

Neurological hemorrhagic complications are unusual in hemophiliacs. Extradural hematoma is an exception, particularly at the cervical level. Less than 10 cases have been reported in the literature. We report a new case which was the inaugural sign of hemophilia A.

Moderate hemophilia A was revealed by post-traumatic cervical extradural hematoma in a 12-year-old boy. Pain in the cervical spine and progressive tetraplegia led to the diagnosis, confirmed by cervical CT scan. The dissonance between the injury and the minor trauma led to hemostasis exploration which revealed factor VIII at 3%. After prompt correction of the deficiency, total laminectomy allow removal of the hematoma. The neurological course was satisfactory.

We stress the specific character of this association and the previously unreported mode of hemophilia disclosure. CT scan and MRI facilitate diagnosis allowing satisfactory course after emergency decompressive laminectomy.