Abstract
Introduction
We report the case of a 2-year-old boy with suspected meningitis who presented with acute onset neck pain and stiffness associated with right-sided weakness and ataxia.
Management
Despite intravenous antibiotics and antiviral treatment, his condition deteriorated. Magnetic resonance imaging demonstrated spontaneous cervical epidural haematoma (C4–C7) extending down to thoracic (T7) level with associated compression of the spinal cord. He was treated successfully by neurosurgical decompression and made a complete recovery.
Discussion
Spinal epidural haematoma is a neurosurgical emergency characterised by extravasation of blood in the spinal epidural space. The clinical presentation particularly in young children can masquerade other conditions such as meningitis. In this article, we discuss our case and review the literature on spontaneous spinal epidural hematoma with an aim to improve awareness of this condition which if not recognised and treated early can lead to significant lifelong morbidity.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Blount J, Doughty K, Tubbs RS, Wellons JC, Reddy A, Law C, Karle V, Oakes WJ (2004) In utero spontaneous cervical thoracic epidural hematoma imitating spinal cord birth injury. Paediatr Neurosurg 40:23–27
Cakir E, Karaarslan G, Usul H, Baykal S, Kuzeyli K, Mungan I, Yazar U, Peksoylu B, Aynaci M, Çakir F (2004) Clinical course of spontaneous spinal epidural haematoma mimicking Guillain Barre syndrome in a child: case report and literature review. Developmental medicine and child neurology December 46(12):838–842
Fok WM, Sun LK, Wong NM, Lau PY, Cheung HM (2007) Spontaneous spinal epidural haematoma in a 15-month-old boy presenting with a wry neck: a case report. J Orthop Surg 15(3):373–375
Fountas KN, M.D., Ph.D., Kapasalaki EZ, M.D., Ph.D., Robinson JS, M.D (2006) Cervical epidural hematoma in children: a rare clinical entity. Case report and review of literature. Neurosurg Focus 20(2):E6
Groen R (2004) Non-operative treatment of spontaneous spinal epidural hematomas: a review of the literature and a comparison with operative cases. ACTA Neurochir 146:103–110
Jackson RR (1869) Case of spinal apoplexy. Lancet 2:5–6
Liao CC, Lee ST, Hsu WC, Chen LR, Lui TN, Lee SC (2004) Experience in the surgical management of spontaneous spinal epidural hematoma. J Neurosurg Spine 100(1):38–45
Liao CC, Hsieh PC, Lin TK, Lin CL, Lo YL, Lee SC (2009) Surgical treatment of spontaneous spinal epidural hematoma: a 5 year experience. J Neurosurgery Spine Oct 11(4):480–486
Lim JJ, Yoon SH, Cho KH, Kim SH (2008) Spontaneous spinal epidural hematoma in an infant: a case report and review of the literature. J Korean Neurosurg Soc 44:84–87
Min S, Duan Y, Jin A, Zhang L (2011) Chronic spontaneous cervicothoracic epidural hematoma in an 8-month-old infant. Ann Saudi Med May-Jun 31(3):301–304
Lee S-C, Lui T-N, Lee S-T (2003) Spontaneous cervical spinal epidural hematoma: a case report. Acta Neurol Taiwan 12:34–37
Towbin A (1964) Spinal cord and brain stem injury at birth. Arch Pathol 77:620–632
Towbin A (1968) Spinal injury related to the syndrome of sudden death (“crib-death”) in infants. Am J Clin Pathol Apri 49:562–567
Viatali AM, Steinbok P (2008) Spontaneous spinal epidural hematoma following weight lifting. Can J Neurol Sci 35:262–264
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jumani, D.B., Littlewood, R., Iyer, A. et al. Spontaneous spinal epidural haematoma mimicking meningitis in a 2-year-old child—a case report and literature review. Childs Nerv Syst 29, 1795–1798 (2013). https://doi.org/10.1007/s00381-013-2130-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-013-2130-8