Spinal epidural hematoma without significant trauma in children: two case reports and review of the literature.

Carlhan-Ledermann, Audrey; Laubscher, Bernard; Steinlin, Maja; Ulrich, Christian T.; Verma, Rajeev Kumar; Rizzi, Mattia; Maduri, Rodolfo; Grunt, Sebastian (2020). Spinal epidural hematoma without significant trauma in children: two case reports and review of the literature. BMC pediatrics, 20(1), p. 77. BioMed Central 10.1186/s12887-020-1957-x

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BACKGROUND

Spinal epidural hematoma without significant trauma is a rare condition with potentially severe outcome. This case report and systematic review of the literature illustrates the clinical presentation, risk factors, evaluation, treatment and outcomes of spinal epidural hematoma without significant trauma in children.

CASE PRESENTATION

We report one case of a 7-year-old girl who developed a neck pain after minor cervical sprain. MRI showed a right posterior epidural hematoma extending from C2/3 to T1. The hematoma was surgically evacuated, and the histopathology showed an arteriovenous malformation. Postoperative MRI showed complete evacuation of the hematoma and no residual vascular malformation. We report a second ASE with idiopathic spinal epidural hematoma of a 4½-year-old boy presenting with neck pain. MRI showed a right-sided latero-posterior subacute spinal epidural hematoma at C3-C5. Owing to the absence of any neurological deficit, the patient was treated conservatively. MRI at 3 months showed complete resolution of the hematoma.

CONCLUSIONS

Spinal epidural hematoma without significant trauma in children is a rare condition. It may present with unspecific symptoms. Screening for bleeding diathesis is warranted and neuroradiologic follow-up is essential to rule out vascular malformation. Whereas most children have a favorable outcome, some do not recover, and neurological follow-up is required.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Neuropaediatrics
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Steinlin, Maja; Ulrich, Christian Thomas; Verma, Rajeev Kumar and Grunt, Sebastian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1471-2431

Publisher:

BioMed Central

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

16 Mar 2020 14:48

Last Modified:

22 May 2020 10:08

Publisher DOI:

10.1186/s12887-020-1957-x

PubMed ID:

32075604

Uncontrolled Keywords:

Spinal epidural hematoma; Hemorrhage; MRI; Paraplegia; Hemophilia; Vascular malformation

BORIS DOI:

10.7892/boris.141156

URI:

https://boris.unibe.ch/id/eprint/141156

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