Title: Rare Cause of Post-Partum Spontaneous Paraplegia: Spontaneous Spinal Epidural Hematoma – MRI Findings a Case Report
Authors: Dr Bhupendra Chaudhary, Dr Seema Alwadhi, Dr Supreethi Kohli, Dr Sahaj Chopra, Dr Vikas Yadav
DOI: http://dx.doi.org/10.18535/jmscr/v3i12.36
Spontaneous spinal epidural hematoma (SSEH) is anextremely rare entity with incidence rate of 0.1 per 100,000 per year and causes sudden onset of neurological deficit in patient in post-partum period with no preceding underlying cause or intra partum cause resulting in spontaneous spinal epidural hematoma. We present a case of sudden onset paraplegia in post-partum period with on investigation shows epidural hematoma in dorsolumbar region with adjacent myelopathic changes. MRI is the investigation of choice to diagnose and to see the extent of lesion and help in planning further management of patient. Our patient went surgical removal of hematoma and in post operated period showed rapid reversal of neurological symptoms. Keywords: Spontaneous spinal epidural hematoma, SSEH, post-partum paraplegia, sudden onset paraplegia 1. Holtås S, Heiling M, Lönntoft M. Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation.Radiology. 1996 May; 199(2):409-13. 2. Byung Suck Baek, M.D., Jin Woo Hur, M.D., Ki Young Kwon, M.D., and Hyun Koo Lee, M.D. Spontaneous Spinal Epidural Hematoma. J Korean Neurosurg Soc. 2008 Jul; 44(1): 40–42. 3. Singh H, Aggarwal Shalini, Gupta Rajat, Yadav RK. Spontaneous Spinal Epidural Haemorrhage. An Unusual Cause of Paraplegia. JIACM 2008; 9(2): 136-9. 4. Beatty RM, Winsten KR. Spontaneous cervical epidural hematoma. A consideration of aetiology. J Neurosurg 1984;61: 143-8. 5. Farias JP, Lima JA, Antunes JL. Subacute cervical epidural hematomas. SurgNeurol1994; 42: 414-6. 6. Leandro U Taniguchi1, Felix H Pahl, José ED Lúcio, Roger S Brock, Marcos QT Gomes, TarsoAdoni, Victor CC Fiorini, Rodrigo C Carvalho, Eli F Evaristo, Eduardo G Mutarelli and Guilherme Schettino; Complete motor recovery after acute paraparesis caused by spontaneous spinal epidural hematoma: case report; BMC Emergency Medicine 2011, 11:10 7. Melanie B. Fukui, Amar S. Swarnkar, and Robert L. Williams; Acute Spontaneous Spinal Epidural Hematomas; AJNR Neuroradiol20:1365–1372, August 1999 8. Hisako Fujimaki, Toshiyuki Nakazawa, Masaki Ueno, Takayuki Imura, Wataru Saito, NaonobuTakahira and Masashi Takaso; Spinal subarachnoid hematoma in a woman with HELLP syndrome: a case report; Journal of Medical Case Reports 2012, 6:152 9. Coulibaly O, Habibou M, Gana R, Maaqili R, Bellakhdar F.; Spontaneous spinal epidural haematoma causing paraplegia: a case report 10. Chen CL, Lu CH, Chen NFl: Spontaneous spinal epidural haematoma presenting with quadriplegia after sit-ups exercise. American Journal of Emergency Medicine 2009; 27: 1170.e3-1170.e7.Abstract
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