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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

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Spontaneous Spinal Epidural Hematoma Report.

Sunil Kukreja¹, Anil Nanda¹

¹Department of Neurosurgery at the Louisiana State University Health Sciences Center, Shreveport, LA.

The Journal of the Louisiana State Medical Society : Official Organ of the Louisiana State Medical Society

|September 7, 2016

Summary

A rare spontaneous spinal epidural hematoma (SSEH) caused severe weakness in a young girl. Early diagnosis and intervention are crucial for better outcomes in pediatric spinal emergencies.

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Area of Science:

Neurology
Neurosurgery
Pediatric Medicine

Background:

Spontaneous spinal epidural hematoma (SSEH) is a rare condition, particularly in pediatric patients.
It can lead to rapid neurological deterioration due to spinal cord compression.

Observation:

A 12-year-old female presented with progressive upper and lower extremity weakness after neck and shoulder pain.
MRI confirmed an epidural hematoma from C6-T2 with specific T1 and T2 signal characteristics.

Findings:

Despite emergent spinal decompression, the patient experienced persistent lower extremity weakness, remaining wheelchair-bound at 3 months.
The case highlights the challenges in managing pediatric SSEH and achieving complete neurological recovery.

Implications:

Emphasizes the need for a high index of clinical suspicion for SSEH in pediatric patients presenting with neurological deficits.
Underscores the importance of timely diagnosis and surgical intervention to mitigate severe, long-term physical and social consequences.