Advertisement

Child's Nervous System

, Volume 35, Issue 2, pp 379–383 | Cite as

Delayed-onset paralysis induced by spontaneous spinal epidural hematoma communicated with hematoma in the paraspinal muscle in a 6-month-old girl: a case report

  • Hiroshi UeiEmail author
  • Yasuaki Tokuhashi
  • Masafumi Maseda
  • Masahiro Nakahashi
  • Hirokatsu Sawada
  • Hiroyuki Miyakata
Case Report
First Online:

Abstract

Spontaneous spinal epidural hematoma (SSEH) very rarely develops in infants younger than 1 year old. To our knowledge, no previous case of delayed-onset paralysis induced by SSEH communicated with hematoma in the paraspinal muscle has been reported in the literature. The authors present the case of a 6-month-old girl with a tumor mass on her back who developed a paresis of her bilateral lower limbs. On spinal magnetic resonance imaging, the epidural mass appeared to be a dumbbell type and communicated with the mass in the paraspinal muscle through T12/L1 intervertebral foramen at the right side. After excision of the mass in the paraspinal muscle, hemi-laminectomy of T10-L3 was performed. No solid lesion was also present in the spinal canal and it was found to be an epidural hematoma. No malignancy was observed on pathological examination, and vascular and nerve system tumors were negative. When a tumor mass suddenly develops on the back of an infant and motor impairment of the lower limbs develops as the mass gradually enlarges, differential diagnosis should be performed taking SSEH into consideration.

Keywords

Infant Spontaneous spinal epidural hematoma Spinal cord compression Dumbbell type 

Abbreviations

SSEH

spontaneous spinal epidural hematoma

MRI

magnetic resonance imaging

This is a preview of subscription content, log in to check access.

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethics approval and consent to participate

This study was approved by the Nihon University Institutional Review Board. Written informed consent was obtained from the patient’s parent.

Consent for publication

Written informed consent was obtained from the patient’s parent for the publication of this manuscript.

Availability of data and materials

All data used and analyzed during this study are available from the corresponding author on reasonable request.

References

  1. 1.
    Groen RJ, van Alphen HA (1996) Operative treatment of spontaneous spinal epidural hematomas: a study of the factors determining postoperative outcome. Neurosurgery 39(3):494–508 discussion 508-499Google Scholar
  2. 2.
    Holtas S, Heiling M, Lonntoft M (1996) Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation. Radiology 199(2):409–413CrossRefGoogle Scholar
  3. 3.
    Kreppel D, Antoniadis G, Seeling W (2003) Spinal hematoma: a literature survey with meta-analysis of 613 patients. Neurosurg Rev 26(1):1–49CrossRefGoogle Scholar
  4. 4.
    Schoonjans AS, De Dooy J, Kenis S, Menovsky T, Verhulst S, Hellinckx J, Van Ingelghem I, Parizel PM, Jorens PG, Ceulemans B (2013) Spontaneous spinal epidural hematoma in infancy: review of the literature and the “seventh” case report. Eur J Paediatr Neurol 17(6):537–542CrossRefGoogle Scholar
  5. 5.
    Min S, Duan Y, Jin A, Zhang L (2011) Chronic spontaneous cervicothoracic epidural hematoma in an 8-month-old infant. Ann Saudi Med 31(3):301–304CrossRefGoogle Scholar
  6. 6.
    Hosoki K, Kumamoto T, Kasai Y, Sakata K, Ito M, Iwamoto S, Komada Y (2010) Infantile spontaneous spinal epidural hematoma. Pediatr Int 52(3):507–508CrossRefGoogle Scholar
  7. 7.
    Ramelli GP, Boscherini D, Kehrli P, Rilliet B (2008) Spontaneous spinal epidural hematomas in children: can we prevent a negative prognosis?--reflections on 2 cases. J Child Neurol 23(5):564–567CrossRefGoogle Scholar
  8. 8.
    Lee JS, Yu CY, Huang KC, Lin HW, Huang CC, Chen HH (2007) Spontaneous spinal epidural hematoma in a 4-month-old infant. Spinal Cord 45(8):586–590CrossRefGoogle Scholar
  9. 9.
    Poonai N, Rieder MJ, Ranger A (2007) Spontaneous spinal epidural hematoma in an 11-month-old girl. Pediatr Neurosurg 43(2):121–124CrossRefGoogle Scholar
  10. 10.
    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 100(1 Suppl Spine):38–45Google Scholar
  11. 11.
    Kalina P, Morris J, Raffel C (2008) Spinal epidural hematoma in an infant as the initial presentation of severe hemophilia. Emerg Radiol 15:281–284CrossRefGoogle Scholar
  12. 12.
    Kim M, Hoffman J, Amin A, Purohit M, Mohan A (2018) Spontaneous spinal epidural hematoma in an infant. Pediatr Emerg Care.  https://doi.org/10.1097/PEC.0000000000001445
  13. 13.
    Riaz S, Jiang H, Fox R, Lavoie M, Mahood JK (2007) Spontaneous spinal epidural hematoma causing Brown-Sequard syndrome: case report and review of the literature. J Emerg Med 33(3):241–244CrossRefGoogle Scholar
  14. 14.
    Caldarelli M, Di Rocco C, La Marca F (1994) Spontaneous spinal epidural hematoma in toddlers: description of two cases and review of the literature. Surg Neurol 41(4):325–329CrossRefGoogle Scholar
  15. 15.
    Pai SB, Maiya PP (2006) Spontaneous spinal epidural hematoma in a toddler--a case report. Child’s Nerv Syst 22(5):526–529CrossRefGoogle Scholar
  16. 16.
    Towbin A (1968) Spinal injury related to the syndrome of sudden death (“crib-death”) in infants. Am J Clin Pathol 49(4):562–567CrossRefGoogle Scholar
  17. 17.
    Towbin A (1964) Spinal cord and brain stem injury at birth. Arch Pathol 77:620–632Google Scholar
  18. 18.
    Yasuoka S, Peterson HA, Laws ER Jr, MacCarty CS (1981) Pathogenesis and prophylaxis of postlaminectomy deformity of the spine after multiple level laminectomy: difference between children and adults. Neurosurgery 9(2):145–152CrossRefGoogle Scholar
  19. 19.
    Abbott R, Feldstein N, Wisoff JH, Epstein FJ (1992) Osteoplastic laminectomy in children. Pediatr Neurosurg 18(3):153–156CrossRefGoogle Scholar
  20. 20.
    Liu Z, Jiao Q, Xu J, Wang X, Li S, You C (2008) Spontaneous spinal epidural hematoma: analysis of 23 cases. Surg Neurol 69(3):253–260 discussion 260CrossRefGoogle Scholar
  21. 21.
    Inamasu J, Hori S, Aoki K, Aikawa N, Maruiwa H, Toyama Y (2000) Spontaneous spinal epidural hematoma. Am J Emerg Med 18(7):837–839CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryNihon University School of MedicineTokyoJapan

Personalised recommendations

Cite article

Buy options