Acute non‐ambulatory tetraparesis in a 6‐month‐old Standardbred weanling caused by a cervical vertebral epidural haematoma

Abstract

Summary A 6‐month‐old Standardbred weanling presented with acute non‐ambulatory tetraparesis. Cranial nerve examination was normal and neuroanatomic localisation suggested there was a focal C1‐C5 spinal cord lesion. Post‐mortem examination identified a cervical vertebral epidural haematoma at the level of C2‐C3 causing spinal cord compression and neurological deficits. Histological examination determined the haematoma was several weeks old making the lesion chronic. Since the clinical progression was acute, this suggests an acute on chronic pathophysiology. Even with no history of trauma, an epidural haematoma should be on the differential list in young horses with acute tetraparesis.

Botryomycosis‐like discospondylitis of the thoracic spine in a Friesian horse with severe bilateral pelvic limb ataxia and paresis

“…A recent clinical commentary by Morgan (2022) focused on the classification and differential diagnosis of equine spinal ataxia. Spinal cord lesions can be classified as intramedullary (neoplastic, vascular, infectious myelopathy and syringohydromyelia), intradural extramedullary (subarachnoid, subdural and intra‐arachnoid masses, such as diverticulum, haemorrhage, haematoma, granuloma, cysts and neoplasia) and the more common extradural (vertebral stenosis, fractures, extradural masses such as haematomas, abscesses, granulomas, neoplasia or degenerative conditions such as intervertebral disc degeneration and facet arthropathy; Allison & Moeller, 2000; Hales et al, 2021; MacMillan et al, 2021; Morgan, 2022; Sponseller et al, 2011).…”

Spinal ataxia: How to distinguish types of spinal cord compression

“…Other than CVSM, there is a lack of high‐powered scientific studies regarding extradural lesions in the horse. There are numerous case reports of extradural compression causing spinal ataxia, including synovial cysts (Fisher & Bowman, 1981), hydatid cysts (Peter et al., 2018), ligamentum flavum hypertrophy (Hellige et al., 2021), intervertebral disc degeneration (Hales et al., 2021), epidural haematoma (MacMillan et al., 2021) and intervertebral disc protrusion. Neoplasia of the cervical vertebrae has been reported to cause extradural spinal cord compression, including haemangiosarcoma (Hirsch et al., 2009; Newton‐Clarke et al., 1994), osteochondroma (Dixon & Anderson, 2021) and vertebral angiosarcoma (Kennedy & Brown, 1993).…”

Cervical haematoma

“…The practice of veterinary medicine especially in a rural situation is often frustrating due to budget constraints and proximity to facilities necessary for a complete clinical work‐up. The attending and referring veterinarians did an excellent work‐up on this patient with a very unusual case presentation (MacMillan et al 2021). The basic neurological examination on a recumbent horse is difficult at the best of times.…”