Acute cervical spinal epidural hematoma with spontaneous resolution--case report

Area of Science:

• Neurosurgery
• Neurology
• Spinal Cord Imaging

Background:

• Spinal epidural hematomas (SEH) are rare but can cause significant neurological deficits.
• Ventral cervical epidural hematomas are particularly uncommon and pose diagnostic challenges.
• Surgical decompression is often considered the standard treatment for SEH.

Observation:

• A 54-year-old male presented with a spontaneous acute ventral cervical epidural hematoma.
• The patient experienced gradual, spontaneous improvement in neurological deficits prior to surgical intervention.
• Serial magnetic resonance imaging (MRI) confirmed the spontaneous resolution of the hematoma.

Findings:

• The patient was managed conservatively with close monitoring.
• Complete resolution of the hematoma was observed on follow-up imaging.
• The patient was discharged neurologically intact approximately one month after symptom onset.

Implications:

• Immediate surgical decompression may not always be necessary for spinal epidural hematomas.
• Conservative management can be a viable option for select cases of SEH, particularly when spontaneous improvement is evident.
• Careful neuroimaging and clinical assessment are crucial in determining the optimal treatment strategy for SEH.