Cervical intraextradural hematoma secondary to radicular artery injury: a case report

A young man presented with a 5-year history of high cervical pain after a blunt blow to the neck and clinical evidence of myelopathy. Preoperative radiographic findings, including metrizamide myelography, CT scan, and vertebral angiography, were consistent with a right C2-3 "dumbell" shaped intradural-extradural tumor. At surgery a firm red-grey mass was found beneath an abnormally thin right C2-3 facet joint. This mass was both intradural and extradural and extended laterally through the root canal to merge with an area of dense adhesions surrounding the vertebral artery. Pathological examination showed no tumor and was consistent with chronic, organized hematoma. Aspects of this unique case of intradural-extradural hematoma in the distribution of a radicular vessel, and possible etiologic considerations are discussed.