J Korean Soc Spine Surg.  2011 Sep;18(3):163-168.

Acute Spontaneous Cervical Spinal Epidural Hematoma with Spontaneous Resolution: A Case Report

• Koh YD
• Kook SH

Abstract

STUDY DESIGN: This is a case report.
OBJECTIVES
We wanted to report on the spontaneous dissolution of acute spontaneous epidural hematoma of the cervical spine and the effectiveness of conservative treatments, in the cases where the symptoms related to spontaneous epidural hematoma improve by themselves in a short period. SUMMARY OF LITERATURE REVIEW: Cases of acute spontaneous epidural hematoma of the cervical spine are rarely reported; surgical decompression procedures have been performed in most of the cases as treatment. However, there are some reported cases of hematoma dissolving spontaneously after a certain period of conservative treatment.
MATERIALS AND METHODS
A 29 year-old female, who had no history of recent trauma, appealed neck pain with radiating pain in her upper right extremity due to acute epidural hematoma of the cervical spine which was diagnosed with MRI. The neck pain and radiating pain showed early recovery and gradual improvement during a period of the following 7 days after occurrence. MRI studies were done after 3 days, 7days, and 1 month from the day of occurrence of the symptoms.
RESULTS
In comparing MRI studies there were significant decreases in the sizes of hematoma, which implied spontaneous dissolution. Almost all the symptoms related to acute spontaneous epidural hematoma vanished after a 1-month period of conservative treatment.
CONCLUSIONS
Decompressive surgical procedure may not be necessary, if the symptoms related to spontaneous epidural hematoma improve by themselves in short period of conservative treatment.

Keyword

Cervical; Epidural hematoma; Spontaneous; Resolution

MeSH Terms

Decompression, Surgical
Extremities
Female
Hematoma
Hematoma, Epidural, Spinal
Humans
Neck Pain
Spine

Figure

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  Fig. 1. MR images on the 3rd hospital day, demonstrating an epidural lesion at the dorsal C6~T1 level as a intermediate to low intensity area on the (A) T2-weighted sagittal image (B) T2-weighted axial image and (C) intermediate to high intensity area on the T1-weighted image (D) T1-weighted axial image.

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  Fig. 2. Serial T2-weighted axial MR images, (A) Heterogeneous lobulated contour lesion compressed the spinal cord on the 3rd hospital day (B) On the 7th hospital day, a vary thin low intensity lesion was observed at the hematoma site (C) One month later, almost hematoma had disappeared (D) 3 months later, hematoma with complete resolution.

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  Fig. 3. Serial T2-weighted sagittal MR images, (A) Heterogeneous lobulated contour lesion compressed the spinal cord on the 3rd hospital day (B) On the 7th hospital day, a vary thin low intensity lesion was observed at the hematoma site (C) One month later, almost hematoma had disappeared (D) 3 months later, hematoma with complete resolution.

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