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Spontaneous spinal epidural hematoma in a toddler--a case report
1Department of Neurosurgery, M.S.Ramaiah Medical College, 737, 14th Cross, Girinagar II Phase, Bangalore, 560085, India. balajipai65@yahoo.co.in
Insights
Spontaneous spinal epidural hematoma (SSEDH) is rare in young children but can cause severe neurological issues. Prompt surgical decompression is crucial for recovery and preventing permanent deficits.
Area of Science:
- Pediatric Neurosurgery
- Spinal Surgery
Background:
- Spontaneous spinal epidural hematoma (SSEDH) is an uncommon condition in children under two years old.
- SSEDH can lead to rapid and severe neurological deterioration.
Observation:
- A case of SSEDH in a 15-month-old boy is presented, diagnosed via MRI.
- Surgical intervention involved suspension laminotomy and clot evacuation 48 hours after symptom onset.
- Post-operative imaging at six months showed successful fusion of the laminotomy.
Findings:
- The patient achieved an excellent neurological recovery following surgical decompression.
- Literature review on pediatric SSEDH is included.
Implications:
- Immediate surgical decompression is vital for preventing permanent neurological deficits in SSEDH cases.
- Laminotomy is recommended over laminectomy in pediatric patients due to a lower risk of spinal deformity.
Objects:
Spontaneous spinal epidural hematoma (SSEDH) is rare in children below the age of 2 years. It can produce rapidly progressive neurological deficits.
Methods:
The authors report a case of SSEDH in a 15-month-old boy diagnosed by MRI. Suspension laminotomy and evacuation of the clot were done 48 h after the onset of symptoms. The patient made excellent neurological recovery. Computed tomography (CT) and MRI scanning carried out 6 months after surgery revealed good fusion of the laminotomy. A brief review of relevant literature is presented.
Conclusion:
Although rare SSEDH requires immediate surgical decompression to avoid any permanent neurological deficit. Reconstructive surgical procedures like laminotomy are preferred in children where the incidence of spinal deformity is high following laminectomy.
