Department of Neurology-Pediatric Neurology, Antwerp University Hospital (UZA), University of Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium; Department of Pediatrics, Antwerp University Hospital, University of Antwerp, Belgium.
Eur J Paediatr Neurol. 2013 Nov;17(6):537-42. doi: 10.1016/j.ejpn.2013.05.012. Epub 2013 Jun 17.
Spontaneous spinal epidural hematomas (SSEH) are a rare cause of spinal cord compression in childhood and especially in infancy. We reviewed the literature and describe a case of an 8-month-old boy with a large spontaneous cervico-thoracic epidural hematoma. With this review we want to detail the importance of early investigation, diagnosis and treatment in infants with SSEH. In our case the infant presented with irritability and crying and an ascending paralysis within four days. Magnetic resonance imaging (MRI) of the spine demonstrated an extensive epidural hematoma between C5 and L1, serious medullar compression and secondary cervical and thoracic medullar edema and hydromyelia. An emergency laminectomy was performed with evacuation of a well organized hematoma. There was a partial recuperation of the neurologic symptoms. Based on the scarce literature which only concerns seven case reports, SSEH is a rare cause of spinal compression in infancy. The presentation is often not specific and neurological symptoms are often lacking in the beginning. However early diagnosis with MRI and prompt neurosurgical intervention are important to improve outcome.
自发性脊柱硬膜外血肿（SSEH）是儿童，特别是婴儿脊髓压迫的罕见原因。我们复习了文献，并描述了一例 8 个月大的男孩患有大的自发性颈胸硬膜外血肿的病例。通过这次复习，我们希望详细说明婴儿 SSEH 早期检查、诊断和治疗的重要性。在我们的病例中，婴儿表现为烦躁和哭泣，并在四天内出现进行性瘫痪。脊柱 MRI 显示 C5 至 L1 之间有广泛的硬膜外血肿，严重的脊髓受压以及继发性颈胸脊髓水肿和脊髓积水。进行了紧急椎板切除术，以清除组织良好的血肿。神经症状部分恢复。基于仅涉及 7 例病例报告的文献，SSEH 是婴儿脊柱压迫的罕见原因。其表现通常不具特异性，且早期神经系统症状往往缺失。然而，早期 MRI 诊断和及时神经外科干预对于改善预后非常重要。
