Spontaneous cervical spinal epidural hematoma: A case report

Spontaneous cervical epidural hematoma is an uncommon cause of acute spinal cord compression. It usually occurs with sudden cervical or interscapular pain. Typically, increasing compression of the spinal cord leads to paralysis within minutes to hours after the onset of symptoms. The authors report a case of spontaneous cervical epidural hematoma with sudden onset of left side complete hemiplegia without neck pain. Cervical spinal image studies revealed acute spinal epidural hematoma with spinal cord compression, therefore, emergency surgical removal of the epidural hematoma was performed. The patient recovered well during the 6 months follow-up period. Acute spinal epidural hematoma is definitely a condition of neurological emergency, and although rare, it must be considered in non-traumatic patients with sudden onset of neurological deficits. The absence of neck pain still cannot rule out the possibility of acute cervical epidural hematoma. Early diagnosis made by image studies is mandatory, and emergency surgical evacuation of the epidural hematoma maximizes the chance of neurological recovery.