European Spine Journal

, Volume 20, Supplement 2, pp 176–179 | Cite as

Spontaneous cervical epidural hematoma during pregnancy: case report and literature review

  • Peng Wang
  • Xiao-tang Xin
  • Hai Lan
  • Cong Chen
  • Bo Liu
Case Report


Spontaneous spinal epidural hematoma (SSEH) during pregnancy is rare and may result in permanent damage if not promptly treated. There were few studies discussing the etiology, presentation and treatment of SSEH during pregnancy. The authors describe a case of spontaneous cervical epidural hematoma during pregnancy, which was diagnosed by magnetic resonance imaging (MRI) and managed with surgical evacuation. A retrospective review of a case of spontaneous epidural hematoma of spine during pregnancy was performed. The clinical features, diagnoses, treatments and outcomes of all cases were analyzed. Precise diagnosis without delay and rapid surgical treatment are essential for the management of SSEH during pregnancy.


Epidural hematoma Spine Spontaneous Pregnancy 


  1. 1.
    Jackson R (1869) Case of spinal apoplexy. Lancet 94(2392):5–6CrossRefGoogle Scholar
  2. 2.
    Liu Z, Jiao Q, Xu J et al (2008) Spontaneous spinal epidural hematoma: analysis of 23 cases. Surg Neurol 69(3):253–260PubMedCrossRefGoogle Scholar
  3. 3.
    Alexiadou-Rudolf C, Ernestus RI, Nanassis K et al (1998) Acute nontraumatic spinal epidural hematomas. An important differential diagnosis in spinal emergencies. Spine 23(1):1810–1813PubMedCrossRefGoogle Scholar
  4. 4.
    Vaya A, Resureccion M, Ricart JM et al (2001) Spontaneous cervical epidural hematoma associated with oral anticoagulant therapy. Clin Appl Thromb Hemost 7(2):166–168PubMedCrossRefGoogle Scholar
  5. 5.
    Miyagi Y, Miyazono M, Kamikaseda K (1998) Spinal epidural vascular malformation presenting in association with a spontaneously resolved acute epidural hematoma. J Neurosurg 88(5):909–911PubMedCrossRefGoogle Scholar
  6. 6.
    Leach M, Makris M, Hampton KK et al (1999) Spinal epidural haematoma in haemophilia A with inhibitors—efficacy of recombinant factor VIIa concentrate. Haemophilia 5(3):209–212PubMedCrossRefGoogle Scholar
  7. 7.
    Samkoff LM, Daras M, Kleiman AR et al (1996) Spontaneous spinal epidural hematoma. Another neurologic complication of cocaine? Arch Neurol 53(8):819–821PubMedGoogle Scholar
  8. 8.
    Nystrom EU, Blomberg SG, Buffington CW et al (1998) Transmural pressure of epidural veins in the thoracic and lumbar spine of pigs. Anesthesiology 89(2):449–455PubMedCrossRefGoogle Scholar
  9. 9.
    Yonekawa Y, Mehdorn HM, Nishikawa M et al (1975) Spontaneous spinal epidural hematoma during pregnancy. Surg Neurol 3(6):327–328PubMedGoogle Scholar
  10. 10.
    Groen RJ, Groenewegen HJ, van Alphen HA et al (1997) Morphology of the human internal vertebral venous plexus: a cadaver study after intravenous araldite CY 221 injection. Anat Rec 249(2):285–294PubMedCrossRefGoogle Scholar
  11. 11.
    Groen RJ, van Alphen HA et al (1997) Operative treatment of spontaneous spinal epidural hematomas: a study of the factors determining postoperative outcome. Neurosurgery 39(3):494–508Google Scholar
  12. 12.
    Bidzinski J (1966) Spontaneous spinal epidural hematoma during pregnancy. Case report. J Neurosurg 24(6):1017Google Scholar
  13. 13.
    Carroll SG, Malhotra R, Eustace D et al (1997) Spontaneous spinal extradural hematoma during pregnancy. J Matern Fetal Med 6(4):218–219Google Scholar
  14. 14.
    Steinmetz MP, Kalfas IH, Willis B et al (2003) Successful surgical management of a case of spontaneous epidural hematoma of the spine during pregnancy. Spine J 3(6):539–542Google Scholar
  15. 15.
    Masski G, Housni B, Ibahiouin K et al (2004) Spontaneous cervical epidural haematoma during pregnancy. Int J Obstet Anesth 13(2):103–106Google Scholar
  16. 16.
    Cywinski JB, Parker BM, Lozada LJ (2004) Spontaneous spinal epidural hematoma in a pregnant patient. J Clin Anesth 16(5):371–375Google Scholar
  17. 17.
    Szkup P, Stoneham G (2004) Case report: spontaneous spinal epidural haematoma during pregnancy: case report and review of the literature. Br J Radiol 77(922):881–884Google Scholar
  18. 18.
    Kelly ME, Beavis RC, Hattingh S (2005) Spontaneous spinal epidural hematoma during pregnancy. Can J Neurol Sci 32(3):361–365Google Scholar
  19. 19.
    Jea A, Moza K, Levi AD et al (2005) Spontaneous spinal epidural hematoma during pregnancy: case report and literature review. Neurosurgery 56(5):E1156Google Scholar
  20. 20.
    Doblar DD, Schumacher SD (2005) Spontaneous acute thoracic epidural hematoma causing paraplegia in a patient with severe preeclampsia in early labor. Int J Obstet Anesth 14(3):256–260Google Scholar
  21. 21.
    Case AS, Ramsey PS (2005) Spontaneous epidural hematoma of the spine in pregnancy. Am J Obstet Gynecol 193(3 Pt 1):875–877Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Peng Wang
    • 1
  • Xiao-tang Xin
    • 1
  • Hai Lan
    • 1
  • Cong Chen
    • 1
  • Bo Liu
    • 1
  1. 1.Department of Spine SurgeryWeihai Municipal HospitalWeihaiChina

Personalised recommendations