An unusual case of ventral spontaneous thoracic epidural hematoma.

Spontaneous spinal epidural hematoma (SSEH) rarely occurs. Without early diagnosis, SSEH can lead to the acute onset of neurologic deficits. We report the case of a 65-year-old male with diabetes mellitus who was admitted to our emergency department with a chief complaint of sharp and severe pain in the left scapula and behind the sternum. He was misdiagnosed with cardiovascular disease until the onset of progressive bilateral paraplegia and lower limb numbness. Magnetic resonance imaging revealed a ventral thoracic SSEH. Surgical treatment to remove epidural hematoma and laminectomy for decompression were performed. Except for urine retention, bilateral lower limb paraplegia and numbness were alleviated postoperatively. Due to the high risk of poor neurological outcomes without treatment or with delayed intervention, timely surgical evacuation of the hematoma and hemostasis are recommended to ensure favorable neurological outcomes.

Traumatic Spinal Epidural Hematoma With Significant Neurologic Findings: A Case Report.

Traumatic spinal epidural hematoma (TSEH) is a rare neurosurgical emergency. Our case report centers around a young 34-year-old female brought into our emergency department after a front and rear motor vehicle collision. Clinical deterioration and imaging studies revealed a large spinal epidural hematoma extending from levels C5 to T2. The patient was subsequently transferred to a different hospital for further management. This case involved a multidisciplinary approach by the combined effort of emergency medicine physicians, neurosurgeons, orthopedic trauma surgeons, general surgeons, radiologists, intensive care specialists, anesthesiologists, paramedics and nurses.

Unilateral Neurological Deficit Due to Spinal Epidural Hematoma Following Midline-Sparing Spine Surgery: A Case Report.

Symptomatic spinal epidural hematoma (SEH) is a rare but well-documented complication in spine surgery, often associated with risk factors such as abnormal coagulation parameters, low platelets, excessive epidural bleeding, and inadequate hemostasis. While bilateral SEH is frequently described in the literature, unilateral SEH following spine surgery is seldom reported. We present a unique case of a unilateral neurological deficit resulting from an SEH following midline-sparing spine surgery due to unilateral drain placement in an 80-year-old male patient without comorbidities and normal coagulation parameters. Subsequent evacuation of the hematoma was done leading to gradual recovery of neurology. This emphasizes the importance of bilateral drain placement in such midline-sparing spine surgeries. This report underscores the significance of early SEH diagnosis and intervention, providing valuable insights into preventive measures and the need for a high index of suspicion in managing this potentially debilitating complication.

Spontaneous Spinal Epidural Hematoma: A Case of a Benign Presentation and Emergency Department Management.

Spontaneous spinal epidural hematomas (SSEHs) are neurological emergencies complicated by a wide array of presentations. In this study, we report a case of a patient who presented with neck pain and was diagnosed with an SSEH with computed tomography (CT) angiography with subsequent confirmation by magnetic resonance imaging (MRI). The high-risk location and size of the lesion guided management and surgical intervention. In a stable patient presenting to the emergency department without focal neurological deficits, clinical suspicion and assessment of risk factors are integral in the evaluation of patient risk and subsequent imaging and intervention.