Non-traumatic Hematomyelia: A Rare Finding in Clinical Practice

Abstract

Non-traumatic haematomyelia is a rare finding of acute onset, which in most cases is the result of arteriovenous malformations (AVM), tumours, coagulation disorders or autoimmune conditions, but may also be secondary to treatment with anticoagulants and radiotherapy. We present the case of a 58-year-old woman with sudden onset cervical pain, followed by asymmetric diminution of strength in the upper limbs with reduced pain sensitivity. The diagnosis of AVM at the C7 and D1 levels was made following cervico-dorsal magnetic resonance imaging and angiography. Treatment was embolization with immediate isolation of the AVM.LEARNING POINTSCentral nervous system lesions (including subarachnoid haemorrhage) can be located in the spine as well as the brain.Subarachnoid haemorrhage can be diagnosed through examination of the cerebrospinal fluid, especially when the CT scan is normal in patients with typical signs of this condition (acute neurological deficits with pain and signs of meningeal irritation like fever or neck rigidity).Non-traumatic haematomyelia is a rare finding.

Dramatic Effect of Botox Injection in Disabling Chronic Migraine Secondary to Inoperable Cerebral Arteriovenous Malformation

“…The cause of brain AVMs is unknown; however, it is possibly multifactorial; apparently both genetic mutation and angiogenic stimulation play roles in AVM development. Some believe that AVMs are congenital, while others advocate an angiopathic reaction, following either a cerebral ischemic or hemorrhagic event as a factor in their development [1,2]. AVM detection rate is 1.21/100,000 person-years (95% confidence interval {CI} 1.02-1.42) and the incidence of AVM-hemorrhage is 0.42/100,000 person-years (95% CI 0.32-0.55) [3].…”

Non‐traumatic hemorrhagic myelopathy in dogs

“…Spinal hemorrhage typically is caused by rupture of veins or arteries, vascular malformations, or bleeding diatheses within the intrinsic spinal cord vasculature or spinal cord meninges 1 . Non‐traumatic spinal hemorrhage (NTSH) is rare in both veterinary and human medicine 1,2 . Sporadic reports of NTSH exist in veterinary medicine, but these are largely confined to case reports, 3–19 with a single study describing 6 cases of spontaneous extradural spinal cord hemorrhage 3 .…”

“… 1 Non‐traumatic spinal hemorrhage (NTSH) is rare in both veterinary and human medicine. 1 , 2 Sporadic reports of NTSH exist in veterinary medicine, but these are largely confined to case reports, 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 with a single study describing 6 cases of spontaneous extradural spinal cord hemorrhage. 3 In comparison, ischemic myelopathies are commonly described in dogs, 20 , 21 , 22 representing 10% of dogs presented to a single referral center over a 1‐year period for investigation of a spinal cord disorder.…”

Severe Mimic of Transverse Myelitis - Spontaneous Non-Traumatic Intramedullary Hematomyelia: A Case Report

“…3 Diagnosis may be challenging, not only because the clinical course depends on the location and severity of the lesion, but because the presentation can either be acute, subacute, or chronic in nature. 4 Two large retrospective studies previously showed that patients initially diagnosed with idiopathic transverse myelitis frequently had alternative diagnoses, which is worrisome with this condition given frequently poor outcomes. Neuroimaging is important to confirm the diagnosis, as magnetic resonance imaging (MRI) can reveal flow voids suggesting a vascular malformation, alterations in signal intensity on T1 and T2 signals due to breakdown of blood products, and increased susceptibility on GRE sequences.…”