Motor Recovery After Acute Hemiparesis Caused By Spontaneous Cervical Spinal Epidural Hematoma: A Case Report

Munkado Wilfried Meuga; Landry Konan; Keableon Louis Derou; Marc Sidoine  Gbazi; Soress  Dongo; Djibi Marcel Okamon; Dominique Ndri Oka

Authors

Munkado Wilfried Meuga Department of Neurosurgery CHU Yopougon, Abidjan Cote d’Ivoire https://orcid.org/0000-0002-9864-1580
Landry Konan Department of Neurosurgery CHU Yopougon, Abidjan Cote d’Ivoire https://orcid.org/0000-0003-2679-3785
Keableon Louis Derou Department of Neurosurgery CHU Bouaké, Bouaké - Cote d’Ivoire https://orcid.org/0000-0002-6753-992X
Marc Sidoine Gbazi Department of Neurosurgery CHU Yopougon, Abidjan Côte d’Ivoire https://orcid.org/0000-0002-1485-3640
Soress Dongo Department of Neurosurgery CHU Bouaké, Bouaké-Côte d’Ivoire https://orcid.org/0009-0009-4047-6891
Djibi Marcel Okamon Department of Neurosurgery CHU Yopougon, Abidjan Cote d’Ivoire https://orcid.org/0000-0003-3998-0205
Dominique Ndri Oka Department of Neurosurgery CHU Yopougon, Abidjan Cote d’Ivoire https://orcid.org/0000-0002-1473-5871

Keywords:

Spontaneous Spinal Epidural Hematoma, cervical medullar compression, corticosteroids, spine

Abstract

Spontaneous Spinal Epidural Hematoma (SSEH) is a rare condition characterized by the accumulation of blood within the epidural compartment of the cervical spinal column, leading to compression of neurological structures. Swift medical and surgical intervention is imperative due to the severe neurological consequences that may arise. In this context, we present the case of a 69-year-old woman who exhibited profound right hemiparesis, ultimately unveiling a posterior epidural compression. Given initial suspicions of a neoplastic process, the administration of 80 mg prednisolone was initiated as an emergency measure, remarkably resulting in rapid clinical amelioration. Subsequently, the planned surgical intervention for this lesion was deferred, and the patient's medical treatment persisted for 6 days. Strikingly, a full recovery of the motor deficit was discerned within 48 hours from the commencement of the medical regimen. This case underscores the successful employment of corticosteroids in the resolution of a SSEH, as evidenced by the complete recovery of motor function within a 48-hour window after the inception of medical intervention.

Author Biography

Munkado Wilfried Meuga , Department of Neurosurgery CHU Yopougon, Abidjan Cote d’Ivoire

Neurosurgeon trained in general neurosurgery and with an interest in spine surgery.

References

Holtås S, Heiling M, Lönntoft M. Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation. Radiology. 1996;199(2): 409-413.

Figueroa J, DeVine JG. Spontaneous spinal epidural hematoma: literature review. J Spine Surg. 2017;3(1): 58-63. https://doi.org/10.21037/jss.2017.02.04.

Lo CC, Chen JY, Lo YK, Lai PH, Lin YT. Spontaneous spinal epidural hematoma: a case report and review of the literatures. Acta Neurol Taiwan. 2012;21(1): 31-34.

Lonjon MMC, Paquis P, Chanalet S, Grellier P. Nontraumatic Spinal Epidural Hematoma: Report of Four Cases and Review of the Literature. Neurosurgery. 1997;41(2): 483-487.

Liu Z, Jiao Q, Xu J, Wang X, Li S, You C. Spontaneous spinal epidural hematoma: analysis of 23 cases. Surgical neurology. 2008;69(3): 253-260.

Wang M, Zhou P, Jiang S. Clinical Features, Management, and Prognostic Factors of Spontaneous Epidural Spinal Hematoma: Analysis of 24 Cases. World Neurosurg. 2017;102: 360-369. https://doi.org/10.1016/j.wneu.2017.02.058.

Zhang B, Chen J, Zou N, et al. Spontaneous resolution and complete recovery of spontaneous cervical epidural hematoma: Report of two cases and literature review. Neurochirurgie. 2019;65(1): 27-31. https://doi.org/10.1016/j.neuchi.2018.10.008.

Akimoto T, Yamada T, Shinoda S, Asano Y, Nagata D. Spontaneous spinal epidural hematoma as a potentially important stroke mimic. J Cent Nerv Syst Dis. 2014;6: 15-20. https://doi.org/10.4137/jcnsd.S13252.

Groen RJ, van Alphen HA. Operative treatment of spontaneous spinal epidural hematomas: a study of the factors determining postoperative outcome. Neurosurgery. 1996;39(3): 494-508; discussion 508-499. https://doi.org/10.1097/00006123-199609000-00012.

Yu JX, Liu J, He C, et al. Spontaneous Spinal Epidural Hematoma: A Study of 55 Cases Focused on the Etiology and Treatment Strategy. World Neurosurg. 2017;98: 546-554. https://doi.org/10.1016/j.wneu.2016.11.077.

Fiani B, Jarrah R, Fiani NJ, Runnels J. Spontaneous cervical epidural hematoma: Insight into this occurrence with case examples. Surg Neurol Int. 2021;12: 79. https://doi.org/10.25259/sni_15_2021.

Xian H, Xu LW, Li CH, et al. Spontaneous spinal epidural hematomas: One case report and rehabilitation outcome. Medicine (Baltimore). 2017;96(44): e8473. https://doi.org/10.1097/md.0000000000008473.

Stetkarova I, Ehler E, Brabec K, et al. Spontaneous spinal epidural haematoma: management and main risk factors in era of anticoagulant / antiplatelet treatment. Neurologia i Neurochirurgia Polska. 2021;55(6): 574-581. https://doi.org/10.5603/PJNNS.a2021.0066.

Holtås S, Heiling M, Lönntoft M. Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation. Radiology. 1996;199(2): 409-413. https://doi.org/10.1148/radiology.199.2.8668786.

Matsumura A, Namikawa T, Hashimoto R, et al. Clinical management for spontaneous spinal epidural hematoma: diagnosis and treatment. Spine J. 2008;8(3): 534-537. https://doi.org/10.1016/j.spinee.2007.01.009.

Fattahi A, Taheri M. Spontaneous resolved cervical spine epidural hematoma: A case report. Surg Neurol Int. 2017;8: 183. https://doi.org/10.4103/sni.sni_223_17.

Unnithan AKA. A brief review of literature of spontaneous spinal epidural hematoma in the context of an idiopathic spinal epidural hematoma. Egyptian Journal of Neurosurgery. 2019;34(1): 21. https://doi.org/10.1186/s41984-019-0046-7.

Shin JJ, Kuh SU, Cho YE. Surgical management of spontaneous spinal epidural hematoma. Eur Spine J. 2006;15(6): 998-1004. https://doi.org/10.1007/s00586-005-0965-8.

Groen RJ. Non-operative treatment of spontaneous spinal epidural hematomas: a review of the literature and a comparison with operative cases. Acta Neurochir (Wien). 2004;146(2): 103-110. https://doi.org/10.1007/s00701-003-0160-9.

Goyal G, Singh R, Raj K. Anticoagulant induced spontaneous spinal epidural hematoma, conservative management or surgical intervention—A dilemma? Journal of Acute Medicine. 2016;6(2): 38-42. https://doi.org/https://doi.org/10.1016/j.jacme.2016.03.006.

Walter S, Phillips D, Wells B, et al. Detection to Hospital Door: Gender Differences of Patients With Acute Stroke Symptoms. Frontiers in Neurology. 2022;13.

Heaton JH, Nebes VL, O'Dell LG, Morris Jr SM, Gelehrter TD. Glucocorticoid and cyclic nucleotide regulation of plasminogen activator and plasminogen activator-inhibitor gene expression in primary cultures of rat hepatocytes. Molecular Endocrinology. 1989;3(1): 185-192.

van Zaane B, Nur E, Squizzato A, et al. Systematic review on the effect of glucocorticoid use on procoagulant, anti-coagulant and fibrinolytic factors. J Thromb Haemost. 2010;8(11): 2483-2493. https://doi.org/10.1111/j.1538-7836.2010.04034.x.

Raasck K, Habis AA, Aoude A, et al. Spontaneous spinal epidural hematoma management: a case series and literature review. Spinal Cord Ser Cases. 2017;3: 16043. https://doi.org/10.1038/scsandc.2016.43.

Motor Recovery After Acute Hemiparesis Caused By Spontaneous Cervical Spinal Epidural Hematoma: A Case Report

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Abstract

Author Biography

Munkado Wilfried Meuga , Department of Neurosurgery CHU Yopougon, Abidjan Cote d’Ivoire

References

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