Spinal epidural hematoma (SEH) is a rare but serious condition. Common causes of SEH
include spinal fracture, spinal trauma, and invasive spinal procedures such as lumbar
puncture, epidural anesthesia, or myelography. A few previous reports have suggested
that SEH could be caused by minor triggers such as spinal manipulation therapy or
spontaneously in rare cases. A 60-year-old man, immediately after stretch exercise,
developed severe back cervicodynia and rapidly progressive weakness of left arm from
SEH. He was treated by decompression laminectomy and evacuation of the hematoma. However,
the upper extremity weakness did not completely resolve. The standard treatment remains
timely surgical decompression and evacuation of the hematoma. Thus, early diagnosis
and treatment can confer a significant prognostic advantage to patients with SEH.
Based on the finding that SEH was caused by a mild mechanical trigger and neurologic
deficits remained in this patient, this report highlights its diagnostic difficulty
as well as the importance of rapid treatment. Emergency physicians should consider
SEH among the differential diagnosis in patients with sudden-onset back pain with
symptoms and signs of spinal cord compression.
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Article Info
Publication History
Accepted:
November 6,
2008
Received:
October 29,
2008
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
