Traumatic lumbar disc extrusion mimicking spinal epidural hematoma: Case report and literature review
Luigi Basile1,2, Lara Brunasso1,2, Rosa Maria Gerardi3
1Department of Neurosurgery, Neurosurgical Clinic, AOUP "Paolo Giaccone", Post Graduate Residency Program in Neurosurgery, Italy.
Background:
Because the neurological presentation of spinal epidural hematomas (SEH) is often not specific, they may be misdiagnosed as acute lumbar disk herniations. Here, we present a case in which a traumatic disc extrusion mimicked an epidural hematoma and reviewed the appropriate literature.
Case Description:
A 27-year-old male sustained a high-energy fall. The lumbar MRI scan showed a L4-S1 ventral medium/high signal intensity mass on the T1- and high signal intensity lesion on T2-weighted images; the original diagnosis was spinal epidural hematoma. However, at surgery, consisting of a left L4 and L5 hemilaminectomy with L4-L5 and L5-S1 laminotomy, an extruded lumbar disc was encountered at the L4-L5 level and removed; no additional pathology or SEH was found at either level.
Conclusion:
On MR, SEH may mimic acute lumbar disk herniations. Depending on the clinical symptoms/signs, surgical intervention will both correctly confirm the diagnosis and relieve neural compression.
