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Spontaneous cervicothoracic epidural misinterpreted as transient ischemic attack (TIA)
Sandeep Bhardwaj1, Manish Chaurasiya2, Sunit Shah1
1Department of Neurosurgery, Advanced Neurology and Superspeciality Hospital, Jaipur, Rajasthan, India.
Surgical Neurology International
|February 7, 2022
Summary
Spontaneous spinal epidural hematoma (SSEH) is a rare cause of spinal cord compression. Prompt diagnosis with MRI and urgent surgical removal are crucial for preventing neurological deficits.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Spinal epidural hematoma (SSEH) is an uncommon condition causing spinal cord compression.
- Acute onset necessitates prompt diagnosis and intervention to prevent lasting neurological damage.
Observation:
- A 15-year-old male presented with sudden hemiparesis.
- Brain MRI was unremarkable, but spinal MRI identified a C7-D1 dorsolateral extradural lesion.
- Surgical exploration revealed and removed an epidural hematoma.
Findings:
- Spontaneous epidural hematomas are rare neurological emergencies.
- MRI is the gold standard for diagnosing SSEH.
- Urgent surgical excision is typically indicated for SSEH.
Implications:
- SSEH can be misdiagnosed as stroke or transient ischemic attack.
- Timely diagnosis and surgical decompression are vital for favorable outcomes.
- This case highlights the importance of considering SSEH in patients with acute neurological deficits.
