Cervical epidural hematoma: a case series highlighting uncommon causes.

Area of Science:

• Neurosurgery
• Neurology
• Radiology

Background:

• Cervical epidural hematoma (CEH) is a rare condition involving blood accumulation in the cervical spine's epidural space, potentially causing spinal cord compression.
• While trauma and iatrogenic factors are common causes, CEH due to neck strain and acupuncture is infrequent.
• Prompt recognition and treatment are crucial due to the potentially devastating nature of CEH.

Purpose of the Study:

• To present two cases of CEH resulting from uncommon etiologies: neck strain and acupuncture.
• To underscore the importance of considering diverse causes for CEH in clinical practice.
• To highlight the necessity of early diagnosis and immediate intervention for CEH.

Main Methods:

• Case 1: An 81-year-old female with left hemiparesis and paresthesia after neck strain.
• Case 2: A 35-year-old male with sudden onset quadriplegia after acupuncture.
• Both cases utilized Magnetic Resonance Imaging (MRI) for diagnosis and underwent immediate surgical decompression.

Main Results:

• MRI revealed significant cervical epidural hematoma with cord compression in both patients (C3-C7 in Case 1, C2-C4 in Case 2).
• Both patients experienced substantial recovery following prompt surgical decompression.
• The findings support the link between unusual events and CEH development.

Conclusions:

• Cervical epidural hematoma, though rare, constitutes a neurosurgical emergency.
• Physicians should maintain awareness of various CEH etiologies, including less common ones.
• Early recognition and immediate treatment are paramount for favorable outcomes in CEH patients.