Spontaneous Spinal Epidural Hematoma in an 11-Month-Old Girl

Abstract

An 11-month-old girl was admitted for a 2-month history of regression of motor milestones and lateralizing neurologic findings. Tests for hypercoagulability were all within normal limits except for a moderately elevated fibrinogen level. Urine and blood cultures were negative for growth. Complete MRI of the spine revealed a well-defined extradural inhomogeneous signal intensity extending from C₄ to T₃ suggestive of a subacute hematoma with evidence of evolving hemorrhagic change. There was no evidence of underlying arterial venous fistula or malformation. She underwent a cervicothoracic laminoplasty and evacuation of the hematoma. The clot was confirmed to be a hematoma on pathologic investigation. She made an uneventful recovery with gradual return of neurologic function. This case represents the longest known duration between initial symptoms and definitive management of spontaneous spinal epidural hematoma.

Spontaneous Spinal Epidural Hematoma

“…However, it has been reported to occur in all age groups, and it is a very rare clinical entity in children. Only 30 pediatric cases of SSEH have been documented in the medical literature 10,15) . The male/female ratio is 1.4 : 1 7) .…”

“…The usual clinical presentation of a spontaneous spinal Spontaneous Spinal Epidural Hematoma ｜BS Baek, et al A B epidural hematoma is sudden stabbing neck or back pain that progresses toward paraparesis or quadriparesis, depending on the level of the lesion and the nerve root 6) . Children often suffer from additional symptoms of irritability, and occasionally urinary retention 10) . In high cervical region, SSEHs could cause spinal shock, leading to fatal condition 3) .…”

Spontaneous Spinal Epidural Hematomas: Case Series with Review of Literature

“…There are only about 30 pediatric cases of SSEH documented in the medical literature. The male/female ratio is 1.4 : 17 (16,17) .…”

“…Symptoms in children may include s of irritability, and occasionally urinary retention (16) . In high cervical region, SSEHs could represent a potentially fatal condition from spinal shock (14) .…”

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

“…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.…”