Spontaneously resolving cervical epidural hematoma presenting with hemiparesis

Area of Science:

• Neurology
• Neurosurgery
• Spinal Cord Medicine

Background:

• Cervical epidural hematoma (CEH) is a rare condition causing neck pain, often presenting with severe motor deficits like paraparesis or tetraparesis.
• CEH can arise spontaneously or secondary to trauma or underlying medical conditions.
• Prompt diagnosis and management are crucial for preventing permanent neurological damage.

Observation:

• A healthy 60-year-old woman developed a spontaneous cervical epidural hematoma while swimming.
• The patient presented with transient hemiparesis, a less common initial symptom for CEH.
• This presentation deviated from the typical paraparesis or tetraparesis observed in most CEH cases.

Findings:

• The patient experienced a spontaneous resolution of her hemiparesis.
• Neurological recovery occurred without the need for surgical decompression.
• The absence of long-term neurological sequelae makes this case particularly noteworthy.

Implications:

• This case underscores the variability in clinical presentations of cervical epidural hematoma.
• It suggests that spontaneous recovery without surgery is possible in select cases of CEH with atypical symptoms.
• Further research into the factors influencing spontaneous resolution in CEH may refine treatment strategies.