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Related Experiment Video

Updated: Apr 7, 2026

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Posttraumatic Cervical Nerve Root Avulsion with Epidural Hematoma.

William C Newman1, Zachary J Tempel1, Elizabeth C Tyler-Kabara2

  • 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

World Neurosurgery
|July 3, 2015
PubMed
Summary

Cervical nerve root avulsion, often from car accidents, can cause pseudomeningoceles. This case highlights a rare associated epidural hematoma, emphasizing the need for careful diagnosis in trauma patients.

Keywords:
Cervical spineEpidural hematomaNerve root avulsionPediatricsTrauma

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Area of Science:

  • Neurology
  • Radiology
  • Trauma Surgery

Background:

  • Cervical nerve root avulsion is a known complication of traction injuries, frequently seen after high-speed motor vehicle collisions.
  • This injury involves the nerve root sleeve being pulled into the intervertebral foramen, causing meningeal tearing and proximal nerve root retraction.
  • While nerve root edema and pseudomeningoceles are common imaging findings, associated epidural hematomas are rarely reported.

Observation:

  • A 3-year-old girl sustained a severe injury after a motor vehicle collision, presenting with flaccid paralysis and sensory loss in her left upper extremity.
  • Cervical spine CT revealed no acute fractures, but MRI demonstrated a noncompressive epidural hematoma (C5-T10) and left brachial plexus abnormalities.
  • MRI confirmed diffuse cervical nerve root edema and C5-T1 nerve root avulsion with pseudomeningoceles, not visible on the initial cervical spine MRI.

Findings:

  • The case presents a rare association of cervical nerve root avulsion with a significant epidural hematoma.
  • Imaging findings included nerve root edema, pseudomeningoceles, and a noncompressive epidural hematoma.
  • The patient's neurological examination showed asymmetric deficits corresponding to the affected brachial plexus.

Implications:

  • This case underscores the importance of considering epidural hematomas in the differential diagnosis of cervical nerve root avulsion, especially with asymmetric neurological deficits.
  • The findings suggest that epidural hematomas, though uncommon, can be associated with traumatic nerve root avulsions and pseudomeningocele formation.
  • Accurate diagnosis through advanced imaging like MRI is crucial for appropriate management, potentially avoiding unnecessary surgical interventions for epidural hematomas before evaluating the underlying nerve injury.