Traumatic Spinal Epidural Hematoma Associated with Cervical Nerve Root Avulsion without Vertebral Fractures: Case...

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Traumatic spinal epidural hematoma (TSEH) is a rare condition.
• TSEH can lead to acute spinal cord compression and irreversible neurological impairment.
• TSEH may also exacerbate cervical nerve root avulsion, a complication rarely reported.

Purpose of the Study:

• To report a rare case of combined TSEH and cervical nerve root avulsion.
• To discuss the diagnostic workup and implications of this combined injury.
• To propose a potential radiological sign associated with nerve root avulsion in TSEH.

Main Methods:

• Case presentation of a 42-year-old female motorcycle accident victim.
• Clinical examination revealing right arm numbness and paresis (C5-T1).
• Magnetic Resonance Imaging (MRI) and Electromyography (EMG) for diagnosis.

Main Results:

• MRI confirmed right anterolateral spinal epidural hematoma (SEH) from C2-C7.
• MRI and EMG findings indicated cervical nerve root avulsion with pseudomeningocele (C4-C5 to C7-T1), suggesting brachial plexus neurotmesis.
• The patient presented with symptoms consistent with cervical plexus syndrome.

Conclusions:

• Spinal epidural hematoma should be considered a potential cause of nerve root avulsion and brachial plexus syndrome.
• Extension of SEH into intervertebral foramina may be a radiological indicator of nerve root avulsion.
• Comprehensive diagnostic evaluation is crucial for cervical plexus syndrome.