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Spontaneous anterior cervicothoracic spinal epidural hematoma extending to clivus in SARS-CoV-2 infection
Gianluca Scalia1, Giuseppe Emmanuele Umana2, Salvatore Marrone3
1Department of Neurosurgery, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy.
Background:
The treatment of spontaneous spinal epidural hematomas (SSEHs), depending on the lesion size and myeloradicular involvement, can be surgical or conservative. Here, we present a 55-year-old patient who sustained a SSEH several months following a systemic SARS-CoV-2 infection.
Case Description:
A 55-year-old immunocompromised female (i.e., history 17 years ago of Hodgkin's lymphoma, nodular sclerosis variant) recently developed a SARS-CoV-2 infection treated with nonsteroidal anti-inflammatory agents. She then reported the sudden onset of cervicodorsalgia after a slight cervical flexion/extension maneuver. The brain and cervicothoracic spine MRI studies documented a clival anterior spinal epidural hematoma with maximum spinal compression at the T1-T2 level; it also extended inferiorly to the T6 level. Two weeks later, the follow-up MRI showed a remarkable reduction in the anteroposterior diameter of the hematoma that correlated with significant neurological improvement and almost complete pain regression. She was discharged after a total 15-day hospital stay, with complete symptoms relief.
Conclusion:
We present a 55-year-old chronically immunocompromised (i.e., due to the history of Hodgkin's lymphoma) female who, following a SARS-CoV-2 infection, developed an anterior SSEH extending from the clivus to the T6 spinal level that spontaneously regressed without surgical intervention.
