Spontaneous spinal epidural haematoma mimicking meningitis in a 2-year-old child—a case report and literature review

Jumani, Deepa Bansi; Littlewood, Robyn; Iyer, Anand; Fellows, G. J.; Healey, Andrew; Abernethy, LJ; Spinty, Stefan; Sarginson, R. E.; Pettorini, Benedetta

doi:10.1007/s00381-013-2130-8

Cited by 13 publications

(13 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, a respiratory tract infection (coughing, infectious state), is described as a predisposing factor in previous cases [3,4] and could possibly explain the vulnerability to bleeding in the first case.…”

Section: Discussionmentioning

confidence: 96%

“…Predisposing factors include coagulopathy, vascular malformations, tumors, anticoagulant therapy or infections [2,3]. A change in intraabdominal and intrathoracic pressure by, for example, coughing and weight lifting, in combination with the lack of valves in the epidural venous plexus, has been described as a possible explanation for the vulnerability to bleeding in this area [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous spinal epidural hematoma in two toddlers: diagnostic pitfalls

Smeets¹,

Akker²,

Peters³

et al. 2016

Pediatr Dimensions

View full text Add to dashboard Cite

We report two boys with a spontaneous spinal epidural hematoma (SSEH). The first child presented at the age of 2 years with back pain and general weakness after a respiratory tract infection. After a first surgical intervention he developed a recurrence of bleeding, necessitating re-intervention. He developed medullary ischemia. Important neurologic deficits with paresis of the lower extremities and bladder dysfunction persisted. The other child presented at the age of 1,5 years with irritability and crying, attributed to a mesenteric lymphadenitis. He underwent a laminectomy with drainage of the hematoma. The postoperative course was uneventful. In both cases, no identifiable cause was found for the bleeding. SSEH is a rare condition, but represents a medical emergency. In most pediatric cases, presentation is atypical with back or neck pain and general irritability as sole initial symptom. Neurologic focal signs can arise hours or days after the onset of the bleeding. Knowledge of SSEH presenting signs and symptoms is important for timely diagnosis and treatment. Although it is mostly a solitary event, we stress the importance of close clinical, and if necessary radiological, follow up.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Spontaneous spinal epidural hematoma in two toddlers: diagnostic pitfalls

Smeets¹,

Akker²,

Peters³

et al. 2016

Pediatr Dimensions

View full text Add to dashboard Cite

show abstract

“…There are several reports of SSEH mimicking meningitis, subarachnoid hemorrhage, GBS and even stroke5101315). Although paraparesis or tetraparesis is a common symptom of cervical SSEH, hemiparesis can also be presented when the hematoma compresses the unilateral corticospinal tract.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Spinal Epidural Hematoma Coexisting Guillan-Barré Syndrome in a Child: A Case Report

et al. 2016

View full text Add to dashboard Cite

Spontaneous spinal epidural hematoma (SSEH) has been reported as a rare cause of spinal cord compression, especially in children. Clinical features are usually nonspecific, although cervicothoracic location of hematoma could be presented with progressive paraplegia. Guillian-Barré syndrome (GBS) is clinically defined as an acute peripheral neuropathy causing progressive limb weakness. Because SSEH and GBS have very similar signs and symptoms, SSEH could be misdiagnosed as GBS. Nevertheless, they can be presented together. We describe a rare case of SSEH coexisting with GBS.

show abstract

“…Spontaneous epidural hematomas have very low incidence rates in the adult population and even lower rates in the pediatric population, with only 9 previous pediatric cases documented [3,4,5,6,7,8,9,10,11]. All 9 of these patients, however, presented with acute neurological deficits and underwent emergency surgical intervention for spinal cord decompression and clot evacuation.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Resolution of Spinal Epidural Hematoma Resulting from Domestic Child Abuse: Case Report

Rangwala¹,

Birk²,

Tobin³

et al. 2016

Pediatr Neurosurg

View full text Add to dashboard Cite

Nonaccidental head injury, as seen in domestic child abuse cases, is often associated with spinal injury, and spinal subdural hematoma is the most frequent diagnosis. While spinal epidural hematomas are a rare occurrence, the incidence of spontaneous epidural hematomas occurring in nonaccidental head injury patients is even lower. Epidural hematomas often result in acute focal neurological deficits necessitating emergent neurosurgical intervention. In patients without focal neurological deficits, conservative management may allow for spontaneous resolution of the epidural hematoma. The authors present the case of a 2-year-old boy with a large spinal epidural hematoma resulting after an event of nonaccidental injury, specifically, domestic child abuse. This patient exhibited no focal neurological deficits and was managed conservatively without surgical clot evacuation. On a follow-up visit, repeat imaging studies demonstrated a stable resolution of spinal epidural hematoma, providing further support for the safety of conservative management in these patients.

show abstract

Spontaneous spinal epidural haematoma mimicking meningitis in a 2-year-old child—a case report and literature review

Cited by 13 publications

References 12 publications

Spontaneous spinal epidural hematoma in two toddlers: diagnostic pitfalls

Spontaneous spinal epidural hematoma in two toddlers: diagnostic pitfalls

Spontaneous Spinal Epidural Hematoma Coexisting Guillan-Barré Syndrome in a Child: A Case Report

Spontaneous Resolution of Spinal Epidural Hematoma Resulting from Domestic Child Abuse: Case Report

Contact Info

Product

Resources

About