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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2018; 37(03): 213-216
DOI: 10.1055/s-0038-1668551
Case Report | Relato de Caso
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Spontaneous Epidural Hematoma of the Cervical Spine Mimicking a Cerebrovascular Accident: A Case Report

Hematoma epidural espontâneo da coluna cervical imitando acidente vascular cerebral: Relato de caso
Mohammad Jamali
2   Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
,
Sepehr Entezam
3   Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
,
Sulmaz Ghahramani
1   Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
› Author Affiliations Funding None.
Further Information

Publication History

22 May 2018

08 June 2018

Publication Date:
22 August 2018 (online)

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Abstract

Objective The present study is a case report of a 57-year-old female with controlled hypertension who presented with spontaneous spinal epidural hematoma (SSEH) mimicking a cerebrovascular accident (CVA) and was successfully treated by surgical decompression.

Methods A 57-year-old woman with a medical history of hypertension presented with a sudden onset of weakness in the right upper and lower extremities. Weakness of grade 3/5 was noted in her right upper and lower extremities, but there was no motor weakness of the right facial muscles. A magnetic resonance imaging (MRI) exam of the cervical spine revealed an epidural hematoma extending from level C5 to level C7, causing spinal cord compression.

Results During surgery, a cervical spinal epidural hematoma (SEH) was evacuated. Postoperatively, the power in both limbs improved to grade 5/5 just after surgery.

Conclusions A high degree of suspicion, meticulous history taking, and physical examination have a great importance in these rare conditions because anticoagulant therapy as a routine treatment for ischemic CVA could be life-threatening.

Resumo

Objetivo O presente estudo se trata de um relato de caso de uma paciente de 57 anos, com hipertensão controlada, que apresentou um hematoma epidural espinhal espontâneo (HEEE) imitando um acidente vascular cerebral (AVC), e que foi tratada com sucesso através de descompressão cirúrgica.

Métodos Uma mulher de 57 anos com um histórico de hipertensão apresentou um súbito princípio de fraqueza nas extremidades superior e inferior do lado direito. Foi notada força muscular de grau 3/5 em suas extremidades superior e inferior do lado direito, mas não houve fraqueza motora dos músculos faciais no lado direito. Um exame de ressonância magnética (RM) da coluna cervical revelou um hematoma epidural estendendo-se do nível C5 ao nível C7, causando uma compressão medular.

Resultados Durante a cirurgia, um hematoma epidural espinhal (HEE) cervical foi removido. No pós-operatório, a força muscular em ambos os membros aumentou para grau 5/5 logo após a cirurgia.

Conclusões Um alto grau de suspeita, um meticuloso acompanhamento do histórico, e a avaliação física possuem grande importância nesses quadros clínicos raros, pois a terapia anticoagulante como procedimento habitual de tratamento para o AVC isquêmico pode apresentar riscos à vida.

Keywords

spontaneous spinal epidural hematoma - cervical spine

Palavras-chave

hematoma epidural espinhal espontâneo - coluna cervical
 

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