Traumatic C1–C3 Spinal Epidural Hematoma Presented with Occipital Neuralgia

Abstract

A 32-year-old woman presented to our hospital with occipital headache for >1 week following head trauma. She showed no other neurologic symptoms. Pain was aggravated by cervical flexion. Magnetic resonance imaging (MRI) findings showed a spinal epidural hematoma (SEH) at the C1 to C3 level. The C2 roots were encircled and compressed by the hematoma. Medication was prescribed and a neck collar was applied for symptom control. After three weeks, her occipital neuralgia disappeared and cervical flexion did not provoke pain. Followup MRI findings showed total resolution of the SEH. The findings of this case illustrate that occipital neuralgia, especially if characterized by rapid onset, can be caused by SEH after trauma.

Cervical epidural hematoma post-trauma: a case report

“…Regarding treatment, our review of the literature has shown that the two attitudes are the same, namely a surgical approach [ 11 - 13 ] or conservative treatment [ 9 , 14 , 15 ], associated in all cases with boluses of corticosteroids with analgesic treatment. Staying in ICU depends on the general clinical state of the patient at admission.…”