Chronic traumatic spinal epidural hematoma in a child

Spinal epidural hematoma (SEH) can lead to progressive neurological deficits that are the result of spinal cord compression. Most of the reported cases of SEH had nontraumatic origins, and they were mainly in the acute stage. Traumatic SEH in a child is rare, and it is also difficult to diagnose because of the nonspecific pain and irritability of the child. We present here the first reported case of chronic traumatic SEH in a 3-yr-old boy. He was admitted with axillary pain and slowly progressive weakness after a fall that had occurred 4 wks before. On admission, he could not stand or hold a spoon. Magnetic resonance imaging revealed epidural hematomas from C5 to C7; these hematomas showed high signal intensity on the T1-weighted images and heterogeneous high-iso signal intensity on the T2-weighted images. After the surgical decompression, the patient showed a complete resolution of symptoms without any neurological sequelae. Our study suggests that a child with unexplained pain and motor weakness should undergo magnetic resonance imaging for making an early diagnosis. Chronic traumatic SEH in a child can be successfully treated by a surgical operation.