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Complete motor recovery after acute paraparesis caused by spontaneous spinal epidural hematoma: case report

BACKGROUND: Spontaneous spinal epidural hematoma is a relatively rare but potentially disabling disease. Prompt timely surgical management may promote recovery even in severe cases. CASE PRESENTATION: We report a 34-year-old man with a 2-hour history of sudden severe back pain, followed by weakness and numbness over the bilateral lower limbs, progressing to intense paraparesis and anesthesia. A spinal magnetic resonance imaging scan was performed and revealed an anterior epidural hematoma of the thoracic spine. He underwent an emergency decompression laminectomy of the thoracic spine and hematoma evacuation. Just after surgery, his lower extremity movements improved. After 1 week, there was no residual weakness and ambulation without assistance was resumed, with residual paresthesia on the plantar face of both feet. After 5 months, no residual symptoms persisted. CONCLUSIONS: The diagnosis of spontaneous spinal epidural hematoma must be kept in mind in cases of sudden back pain with symptoms of spinal cord compression. Early recognition, accurate diagnosis and prompt surgical treatment may result in significant improvement even in severe cases

Keywords : Acute Disease,Adult,Anesthesia,Back,Back Pain,complications,diagnosis,Diagnosis,Differential,etiology,Face,Hematoma,Hematoma,Epidural,Spinal,history,Humans,Laminectomy,Lower Extremity,Magnetic Resonance Imaging,Male,Movement,Pain,Paraparesis,Paresthesia,pathology,Spinal Cord,Spinal Cord Compression,Spine,surgery,Thoracic Vertebrae,, Motor,Recovery,After,Acute,Paraparesis, synvisc hip injection side effects

Date of Publication : 2011 Jul 27

Authors : Taniguchi LU;Pahl FH;Lucio JE;Brock RS;Gomes MQ;Adoni T;Fiorini VC;Carvalho RC;Evaristo EF;Mutarelli EG;Schettino G;

Organisation : Discipline of Emergency Medicine, Faculdade de Medicina da Universidade de Sao Paulo, Av, Dr, Eneas de Carvalho Aguiar 255, sala 5023, Sao Paulo, Brazil. leandrout@hotmail.com

Journal of Publication : BMC Emerg Med

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21794133

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