Open AccessA rare case of spontaneous spinal epidural hematoma in a 43‐year‐old man
Author(s) -
Ali Shiraz Siddiq,
Paramanathan Natasha,
Gilligan Peadar
Publication year - 2021
Publication title -
journal of the american college of emergency physicians open
Language(s) - English
Resource type - Journals
ISSN - 2688-1152
DOI - 10.1002/emp2.12532
Subject(s) - medicine , hematoma , epidural hematoma , neurological deficit , surgery , neck pain , stroke (engine) , differential diagnosis , magnetic resonance imaging , emergency department , dissection (medical) , back pain , spinal epidural hematoma , anesthesia , radiology , mechanical engineering , alternative medicine , pathology , psychiatry , engineering
Spontaneous spinal epidural hematoma is a rare neurosurgical condition that is often difficult to diagnose in the emergency department and can cause permanent neurological deficits if diagnosis is delayed or incorrect. We present the case of a 43‐year‐old man who was initially investigated for cardiac events, suspected posterior circulation stroke, or arterial dissection. All investigations were normal, which led us to perform magnetic resonance imaging of the brain, neck, and cervicothoracic spine, which revealed spontaneous spinal epidural hematoma. Publication of this case raises awareness of this rare neurosurgical emergency and the importance of differential diagnosis to avoid misdiagnosis in patients presenting with sudden‐onset cervicothoracic back pain radiating to the upper limbs bilaterally with neurological deficit and a history of discectomy or receiving anticoagulants. Our study highlights the importance of early discussions with the consultant and specialty involvement in such cases.