Spontaneous spinal haematomas

Abstract

A series of 10 surgically treated "spontaneous" spinal haematomas (7 cases with epidural, 3 with intramedullary location), is presented. Symptomatology was rarely acute. Clinical onset was mostly dominated by spinal or radicular pain, followed by severe motor deficit. Surgical outcome was satisfactory in the majority of cases. Age, duration of symptoms, haematoma site and size appeared to have no influence on final outcome. This was significantly correlated only with the preoperative neurological condition.

Spontaneous spinal epidural hematoma in a 4-month-old infant

“…In our review of English literature, only eight cases below the age of 2 years had been reported with no age below the first year of life (Table 1). [4][5][6][7][8][9] The term 'crib death' has been used to describe sudden unexplained death of neonates. 10 In postmortem examination of infants with 'crib death', spinal epidural hematomas were the causal factor in 10% of cases.…”

“…[4][5][6][7][8][9] This region is more commonly affected as a result of significant disproportion of the weight ratio of the head to the body in pediatric population, in which the head proportion is larger and heavier than in adults. In addition, gaining the head control is an important neuromuscular development milestone during the first 4-6 months of life.…”

“…A summary of presenting symptoms and signs from the reported cases includes irritability, abdominal fullness and pain, neck pain, torticollis, rigid neck position, staggering gait, and fever. [4][5][6][7][8][9] The innumerable clinical presentations often result in delaying diagnosis. In our case, the infant initially presented with irritable crying, neck stiffness, and limited range of motion of the neck, followed by neurological deficit as showed by decrease in ability to roll over and decrease limb movements.…”

“…In our review of reported cases in toddlers, most of the cases had complete functional recovery including our patient, suggesting the surgical decompression results in good outcome even with delayed diagnosis. [4][5][6][7][8][9] Laminectomy of the involved segment is the main surgical modality in most cases. However, some authors are concerned that laminectomy will limit normal development in young children, resulting in kyphosis, lordosis, scoliosis or tethered cord.…”

Spontaneous Spinal Epidural Hematoma in an Infant : A Case Report and Review of the Literature

“…Although this condition occurs in all ages, it has a preponderance in older aged patients who have received anticoagulants or antiplatelet drugs and therefore have bleeding or coagulation defect tendencies. SSEH is rare in children and only 12 infant cases have been reported in the literature 4,10,12,[15][16][17]19,21,24,26) . While the lesion is located in the thoracolumbar lesion in older patients, the cervicothoracic site is more common in children 21) .…”