Hemiparesis in spontaneous spinal epidural haematoma: a possible stroke imitator.
BMJ Case Rep. 2018 Jan 26;2018:
Authors: Patel R, Kumar A, Nishizawa Ok, Kumar N
Summary
Spontaneous spinal epidural haematoma (SSEH) is a uncommon situation that requires pressing surgical intervention in an effort to stop everlasting neurological deficit. SSEH generally presents as a paraparesis or tetraparesis. SSEH presenting as a hemiparesis is much less widespread and in such conditions, it may be mistaken for a cerebrovascular accident (CVA). Thrombolytic or anticoagulant remedy for CVA can doubtlessly worsen the neurological deficit. We report one such case of SSEH misdiagnosed as a CVA. Therapy with tissue plasminogen activator led to worsening of his situation. On a subsequent cervical backbone MRI, an epidural haematoma extending from C3 to C5 was detected and handled with laminectomy and evacuation. Surgical intervention led to vital enchancment from American Spinal Harm Affiliation Scale (ASIA) B to ASIA E. Presence of medical options resembling Horner’s syndrome, Brown-Sequard syndrome and the absence of cranial nerve palsies in acute hemiparesis are indicative of SSEH quite than CVA.
PMID: 29374642 [PubMed – in process]