Cervical epidural hematoma in children: a rare clinical entity

Case report and review of the literature

Kostas N. Fountas M.D., Ph.D., Eftychia Z. Kapsalaki M.D., Ph.D., and Joe Sam Robinson M.D.
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  • Departments of Neurosurgery and Neuroradiology, Medical Center of Central Georgia, School of Medicine, Mercer University, Macon, Georgia
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✓ Pediatric spinal epidural hematoma is a very rare clinicopathological entity. In the vast majority of cases, spinal epidural hematomas have a nonspecific clinical presentation; this, along with their rapid progression, makes their early diagnosis and prompt surgical evacuation critical. Magnetic resonance imaging is the neuroimaging modality of choice, whereas hemilaminectomy or laminectomy is the indicated surgical intervention. The outcome is good when hematoma evacuation is performed before the onset of complete sensorimotor paralysis.

In this communication, the authors describe a 12-year-old girl with a traumatic acute cervical epidural hematoma. This lesion was successfully evacuated through a hemilaminectomy, and the patient had an excellent outcome. The pertinent literature is reviewed in terms of the incidence, origin, management, and prognosis of this rare and potentially disastrous clinical entity.

Abbreviations used in this paper:

CT = computerized tomogra phy; Gd-DTPA = gadolinium diethylenetriamine pentaacetic acid; MR = magnetic resonance.

✓ Pediatric spinal epidural hematoma is a very rare clinicopathological entity. In the vast majority of cases, spinal epidural hematomas have a nonspecific clinical presentation; this, along with their rapid progression, makes their early diagnosis and prompt surgical evacuation critical. Magnetic resonance imaging is the neuroimaging modality of choice, whereas hemilaminectomy or laminectomy is the indicated surgical intervention. The outcome is good when hematoma evacuation is performed before the onset of complete sensorimotor paralysis.

In this communication, the authors describe a 12-year-old girl with a traumatic acute cervical epidural hematoma. This lesion was successfully evacuated through a hemilaminectomy, and the patient had an excellent outcome. The pertinent literature is reviewed in terms of the incidence, origin, management, and prognosis of this rare and potentially disastrous clinical entity.

Abbreviations used in this paper:

CT = computerized tomogra phy; Gd-DTPA = gadolinium diethylenetriamine pentaacetic acid; MR = magnetic resonance.

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