Spontaneous Spinal Epidural Hematoma Mimicking Lymphoma or Tumor Metastasis

Spontaneous spinal epidural hematoma (SSEH) is an uncommon condition causing spinal cord compression and neurologic deficits. Clinical history with MR imaging has been authorized as the most reliable method for diagnosis of SSEH. Aggressive surgical decompression within 36 hours is the golden standard management for patients of SSEH, especially for patients with complete sensorimotor loss. Early rehabilitation following operation plays an important role in neurological recovery in SSEH. We present a paraplegic man with sudden onset of severe upper back pain when sitting calmly, followed by abruptly neurologic deteriorations including sensory loss below T-6 dermatome and paralysis. He was initially diagnosed as spinal lymphoma or metastasis by MR imaging of thoracic spine. Emergency surgical decompression was preformed within 24 hours. The pathology of the tumor turned out to be spinal hemangioma. After surgical intervention, our patient underwent a series of rehabilitation treatment. The lower extremity function gradually recovered and he was independently ambulating with a walker at ten month follow-up. Voluntary bowel function also returned but thrice daily intermittent catheterization remained necessary for neurogenic bladder.

並列關鍵字

spontaneous spinal epidural hematoma ； paraplegia ； thoracic spine

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