A Case of Spontaneous Spinal Epidural Hematoma Mimicking a Stroke

作者：Son Seungnam; Kang Dong Ho; Choi Dae Seob; Kim Soo Kyoung; Lim Byeong Hoon; Choi Nack Cheon^*

来源：Neurologist, 2012, 18(1): 41-43.

DOI：10.1097/NRL.0b013e31823d7ade

• stroke mimics
• recombinant tissue plasminogen activator (rt-PA)
• thrombolysis
• spontaneous spinal epidural hematoma (SSEH)

Introduction: For intravenous (IV) thrombolytic therapies to be effective, a correct diagnosis of acute ischemic stroke must be made within 3 hours from the onset of symptoms, a relatively short window period. However, obtaining a diagnosis in the time frame is not easy; a wide variety of conditions mimic a stroke, including seizures, migraine, and even a spinal mass, and often these are diagnosed as acute ischemic stroke and receive thrombolytic therapy. %26lt;br%26gt;Case Report: A patient presented suffering progressive and fluctuating painful triparesis coupled with acute onset dissociated sensory loss. The patient complained of dysarthria and transient altered mentality at the onset of symptoms; therefore, we suspected an ischemic infarction of the brainstem and spinal cord accompanied by vertebral artery dissection. As the time at diagnosis was 2 hours 30 minutes after symptom onset, we started IV thrombolytic treatment using recombinant tissue plasminogen activator. Magnetic resonance imaging during the recombinant tissue plasminogen activator infusion revealed a spontaneous spinal epidural hematoma (SSEH) of the cervical and thoracic spine, leading the patient to undergo an emergency surgery. %26lt;br%26gt;Conclusions: SSEH is an uncommon clinical condition, and a manifestation of SSEH with anterior spinal artery syndrome is also rare. Furthermore, an emergency operation after IV thrombolytic treatment is an extraordinary situation.

• 出版日期2012-1