Department of Hand Surgery, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.
Department of Orthopaedic Surgery, Nagano Red Cross Hospital, Nagano, Japan.
Global Spine J. 2015 Oct;5(5):e44-7. doi: 10.1055/s-0034-1398489. Epub 2015 Jan 7.
Study Design Case report. Objective To describe a patient with a recurrent spontaneous spinal epidural hematoma (SSEH) during pregnancy that had spontaneous remission. Methods A 27-year-old primigravida at 37 weeks' gestation suddenly felt a strong left shoulder pain without any trauma. She had a history of fenestration for a spontaneous cervical hematoma when she was 18 years old. An emergency magnetic resonance imaging revealed a recurrence of the cervical epidural hematoma at the C4-T1 level, but she had no paralysis. Results The patient subsequently underwent a cesarean section and delivered a healthy male infant. Her spinal epidural hematoma disappeared. Multislice computed tomography showed no evidence for a vascular malformation or tumor. Three years after the initial cesarean section, she underwent a second one and delivered another male infant. Conclusions We report on a rare case of recurrent SSEH during pregnancy with no neurologic deficits that was treated nonoperatively with close observation and resulted in spontaneous resolution. In such patients with no neurologic deficits, nonoperative management with close observation may be a reasonable alternative.
病例报告。目的：描述一例妊娠期间复发性自发性硬脊膜外血肿（SSEH）患者，其自发性缓解。方法：一位 27 岁的初产妇，妊娠 37 周，突然感到左侧肩部剧痛，无任何创伤史。她曾于 18 岁时因自发性颈血肿而行开窗术。急诊磁共振成像显示 C4-T1 水平的颈椎硬脊膜外血肿复发，但她没有瘫痪。结果：患者随后行剖宫产，娩出一健康男婴。其硬脊膜外血肿消失。多层计算机断层扫描未发现血管畸形或肿瘤的证据。初次剖宫产三年后，她再次行剖宫产，娩出另一名男婴。结论：我们报告了一例罕见的妊娠期间复发性 SSEH 病例，患者无神经功能缺损，经密切观察非手术治疗后自发性缓解。对于无神经功能缺损的此类患者，密切观察的非手术治疗可能是一种合理的选择。
