eISSN: 1509-572x
ISSN: 1641-4640
Folia Neuropathologica
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2/2022
vol. 60
 
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abstract:
Case report

Spontaneous cervical epidural haematoma mimicking stroke: a case report and literature review

Tian Lv
1
,
Yaya Bao
2
,
Jingjing Lou
1
,
Dadong Gu
1

1.
Zhuji Hospital Affiliated of Shaoxing University, China
2.
Medical College of Shaoxing University, China
Folia Neuropathol 2022; 60 (2): 261-265
Online publish date: 2022/06/30
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Spontaneous spinal epidural haematoma (SSEH) is a rare disease that requires emergency decompression or haematoma evacuation to prevent permanent neurological deficits. Hemiparesis is an extremely rare presentation of SSEH, commonly misdiagnosed as stroke. With the help of case studies and references, this paper comprehensively discusses the effective methods to distinguish SSEH from stroke and provides theoretical support and ideas for rapid and accurate identification of SSEH.

Herein, we report on the case of a 51-year-old man with SSEH who presented with acute hemiparesis and posterior neck pain. Cervical computed tomography (CT) revealed cervical degeneration. A carotid CT angiogram revealed a high-density mass in the C2-C5 right posterolateral epidural region. Cervical spine magnetic resonance imaging showed SSEH. The patient was conservatively treated and discharged following a full recovery.

Rapid identification of SSEH continues to present a great challenge for neurologists. A soft tissue CT scan can be used to quickly and accurately identify SSEH; however, in the absence of cranial signs, Brown-Sequard syndrome, Lhermitte’s sign and Horner syndrome should be used to differentiate SSEH from stroke.
keywords:

spontaneous spinal epidural haematoma, stroke, CT, Lhermitte’s sign

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