Extensive spontaneous spinal epidural hematoma in infancy. Case report

Abstract

Introduction: Spontaneous spinal epidural hematomas are a rare condition of spinal cord compression. We report a case of spontaneous spinal epidural hematoma in a child with neurological deficit. Case presentation: A 5-year-old male child with walking difficulty for 15 days. Clinical examination revealed spastic paraparesis and pyramidal signs. Magnetic resonance imaging of the cervical and thoracic spine showed extensive epidural hematoma (C7–T4) with significant medullary edema. Laminotomy was performed for decompression followed by drainage of the hematoma. Spontaneous spinal epidural hematoma usually occurs in the absence of identifiable etiology. The clinical presentation in children is nonspecific. The treatment is based on surgical decompression mainly by laminotomy performed within 48 hours of hematoma formation. Conclusion: In the case presented, the child remained paraparetic despite surgical decompression. The timing (>48 hours) of the surgical procedure probably influenced the poor prognosis.