Spontaneous cervical epidural hematoma: Case report and literature review

BACKGROUND Spontaneously occurring epidural hematomas for which no etiology is identified are rare phenomenon. These are often neurosurgical emergencies; therefore, prompt diagnosis and treatment are paramount. Because of the rarity of this condition, we have illustrated in this recent case its presentation, evaluation and management. METHODS A 63-year-old male presented to our emergency room with right-sided hemiparesis and contralateral hypesthesia, consistent with a C5 Brown-Sequard syndrome. An initial evaluation for cerebral infarction was unremarkable, including A negative brain magnetic resonance image. Further imaging revealed a cervical epidural hematoma of unknown etiology. RESULTS The patient underwent emergent laminectomy for decompression and evacuation of the hematoma within 24 hours of his presentation to the emergency room. The patient's symptoms improved remarkably after surgery and a 4-month follow-up imaging evaluation revealed no recurrence of his hematoma. CONCLUSION This report highlights the various presentations, evaluation, and management options for this rare diagnosis. It emphasizes the necessity of prompt diagnosis for possible emergent intervention. (C) 2004 Elsevier Inc. All rights reserved.