Ultrasound diagnosis of neonatal spinal epidural hemorrhage

Leadman, M; Seigel, Sidney; Hollenberg, Robert D.; Caco, Christopher

doi:10.1002/jcu.1870160614

Cited by 15 publications

(5 citation statements)

References 7 publications

(1 reference statement)

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“…The observation of paralysis or extreme hypotonia in a newborn infant is most frequently due to a birth-related spinal cord injury although neuromuscular diseases, severe brachial plexopathies and cerebral palsy are all in the differential diagnosis [1, 2, 3]. The presence of neonatal intrapartum cerebral anoxia can further complicate the assessment.…”

Section: Discussionmentioning

confidence: 99%

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In utero Spontaneous Cervical Thoracic Epidural Hematoma Imitating Spinal Cord Birth Injury

Blount¹,

Doughty²,

Tubbs³

et al. 2004

Pediatr Neurosurg

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A neonate male born cesarian due to a breech presentation was noted to have no spontaneous movements of the limbs after delivery. Radiographs were not demonstrative of pathology. However, MRI revealed a large intraspinal mass with significant distortion of the cervicothoracic spinal cord. At operation, a brown, fibro-gelatinous, moderately adherent mass was evident extradurally dorsal to the spinal cord. It was noted to extend anterolaterally to the left such that the cord was deviated anteriorly and to the right. There was no indication of the mass being under pressure but the cord was not pulsatile. There was sufficient mass to the anterolateral component of the cord that it appeared rotated to the right within the canal. The right cervical roots exited dorsally, with a markedly lengthened course through the spinal canal before exiting above their respective pedicles. Histology was that of blood clot. The patient clinically demonstrated no neurologic improvement post-operatively. Now, six months after surgery, the patient has still had no significant change in clinical function. To our review, this is the first reported case of a spontaneous spinal epidural hematoma mimicking a birth-related spinal injury.

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Section: Discussionmentioning

confidence: 99%

“…MRI allows multiplanar evaluation and may reveal evidence of direct injury to the spinal cord and/or associated paraspinal soft tissue injuries [8]. Other authors have extolled ultrasound due to its high resolution and ease of application to a severely ill neonate [1, 3, 11, 12]. …”

Section: Discussionmentioning

confidence: 99%

In utero Spontaneous Cervical Thoracic Epidural Hematoma Imitating Spinal Cord Birth Injury

Blount¹,

Doughty²,

Tubbs³

et al. 2004

Pediatr Neurosurg

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“…Despite its advantages, there has been a scarcity of literature detailing the use of ultrasound for the diagnosis of SEH. Leadman et al 14 described a successful case of SEH diagnosed using ultrasound in 1988. Since then, a few other cases have been reported.…”

Section: Case Seriesmentioning

confidence: 99%

Spinal Ultrasound: A Safe and Valuable, but Underutilized Imaging Modality to Evaluate Epidural Hematomas in Infants

Maheshwari,

Ogu,

Adindu

et al. 2023

Newborn

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This paper aims to highlight the utility of spinal ultrasound as a valuable and safe diagnostic tool for spinal epidural hematomas in neonates and young infants. The accessibility, cost-effectiveness, and accuracy of spinal ultrasound make it an appealing alternative to magnetic resonance imaging (MRI). However, despite its potential benefits, spinal ultrasound remains underutilized in clinical practice. In this paper, we present a case study where spinal ultrasound successfully diagnosed a spinal epidural hematoma in a neonate. Additionally, a comprehensive review of current literature demonstrates a consensus on the advantages of spinal ultrasound for assessing spinal lesions in young infants and neonates. The findings of this study emphasize the importance of incorporating spinal ultrasound into clinical practice for more timely and convenient diagnosis of suspected spinal epidural hematoma in neonates and young infants.

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“…Follow-up scans are useful in tracking evolution/regression of hematoma as well as in evaluation of cord myelomalacia, which presents as persistently increased cord echogenicity. [17]Neuroblastoma or other neurogenic tumors with intraspinal extensionNeurogenic tumors such as neuroblastoma or ganglioneuroblastoma may show intraspinal extension which can be visualized on sonography Figure 15.MeningitisMeningitis is an important cause of infantile morbidity and mortality, and its timely diagnosis and treatment is imperative to prevent neurological sequelae. Meningitis is essentially an inflammatory response of the pia-arachnoid mater and subarachnoid space CSF to the offending pathogen.…”

Section: Spinal Pathologiesmentioning

confidence: 99%

“…Follow-up scans are useful in tracking evolution/regression of hematoma as well as in evaluation of cord myelomalacia, which presents as persistently increased cord echogenicity. [17]…”

Section: Spinal Pathologiesmentioning

confidence: 99%

Neonatal and infantile spinal sonography: A useful investigation often underutilized

Nair

Sreenivas

Gupta

et al. 2016

Indian Journal of Radiology and Imaging

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Sonography is an ideal, effective, noninvasive tool for evaluation of the spinal cord in neonatal and early infantile age groups owing to lack of ossification of the posterior elements of spine. Understanding normal anatomical appearances is a prerequisite for the interpretation of various pathologies of the spinal canal and its contents. This review elucidates normal appearances of the spinal cord in this age group, in both axial and sagittal planes. Usefulness of Doppler sonography is briefly discussed, and special emphasis is placed on normal anatomical variants that may mimic spinal abnormalities. Sonographic appearances of common intraspinal pathologies, both congenital and acquired, are exhaustively described. Key points regarding sonographic diagnosis of important spinal anomalies are emphasized and explained in detail. To conclude, spinal ultrasound is a reliable and widely available screening tool, albeit the usefulness of which is often underestimated.

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Ultrasound diagnosis of neonatal spinal epidural hemorrhage

Cited by 15 publications

References 7 publications

In utero Spontaneous Cervical Thoracic Epidural Hematoma Imitating Spinal Cord Birth Injury

In utero Spontaneous Cervical Thoracic Epidural Hematoma Imitating Spinal Cord Birth Injury

Spinal Ultrasound: A Safe and Valuable, but Underutilized Imaging Modality to Evaluate Epidural Hematomas in Infants

Neonatal and infantile spinal sonography: A useful investigation often underutilized

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