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Spontaneous spinal epidural hematoma: a case report.
Amanda J Dinsmore1, Ralph B Leonard, David Manthey
1Department of Emergency Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina 27157-1089.
The Journal of Emergency Medicine
|April 20, 2005
Summary
A man experienced delayed diagnosis of spontaneous spinal epidural hematoma after a car crash. Prompt surgical intervention led to successful treatment of his neurological symptoms.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Spinal epidural hematomas (SSEH) are rare, often presenting with acute, severe symptoms.
- Delayed diagnosis of SSEH can lead to significant neurological deficits.
Observation:
- A 59-year-old male presented with bilateral shoulder pain post-motor vehicle crash.
- He had multiple emergency department visits for back pain with fluctuating neurological symptoms, including lower extremity weakness and urinary retention.
Findings:
- Magnetic Resonance Imaging (MRI) confirmed a spontaneous spinal epidural hematoma (SSEH) at the cervicothoracic junction.
- The patient underwent successful cervical hemilaminectomy for hematoma evacuation.
Implications:
- This case highlights the importance of considering rare diagnoses like SSEH in patients with persistent or evolving neurological symptoms, even after minor trauma.
- Timely diagnosis and surgical decompression are crucial for favorable outcomes in SSEH.
- Multidisciplinary collaboration between emergency medicine, neurology, and neurosurgery is key for managing complex spinal emergencies.