Aponte-Caballero Rafael, Osejo-Arcos Valentina, C Luis, Madrinan-Navia Humberto, S Mario, Riveros-Castillo William Mauricio, G Javier, Peña Camilo E
Center for Research and Training in Neurosurgery (CIEN), Bogotá, Colombia.
Turk Neurosurg. 2025;35(4):672. doi: 10.5137/1019-5149.JTN.46720-24.2.
Traumatic spinal epidural hematoma (TSEH) is a rare condition that may cause acute spinal cord compression and lead to irreversible neurological impairment. TSEH not only compresses the cord, but it can also worsen cervical nerve root avulsion. To our knowledge, only five cases of combined TSEH and cervical nerve root avulsion have been reported in the literature. We present the case of a 42-year-old woman who suffered a motorcycle accident. On admission, she presented with mild traumatic brain injury and cervical spine and right shoulder trauma. A physical examination revealed numbness and flaccid paresis in her right arm, compromising the C5 to T1 dermatomes and myotomes. MRI images showed evidence of a right anterolateral spinal epidural hematoma (SEH) that extended from the C2 to C7 vertebral levels. MRI and electromyography findings of the presence of a pseudomeningocele from the C4-C5 to C7-T1 levels indicating brachial plexus neurotmesis supported the presence of a cervical nerve root avulsion associated with TSEH. Cervical plexus syndrome requires a comprehensive diagnostic workup. SEH should be considered a cause of nerve root avulsion and brachial plexus syndrome. We believe that the extension of SEH into the intervertebral foramina could be a radiological sign related to nerve root avulsion.
创伤性脊髓硬膜外血肿（TSEH）是一种罕见的病症，可能导致急性脊髓受压并引发不可逆的神经功能损害。TSEH不仅会压迫脊髓，还会加重颈神经根撕脱伤。据我们所知，文献中仅报道了5例TSEH合并颈神经根撕脱伤的病例。我们报告了一名42岁女性的病例，她遭遇了摩托车事故。入院时，她表现为轻度创伤性脑损伤以及颈椎和右肩创伤。体格检查发现其右臂麻木和弛缓性麻痹，累及C5至T1皮节和肌节。MRI图像显示存在从C2至C7椎体水平延伸的右侧前外侧脊髓硬膜外血肿（SEH）。MRI和肌电图检查结果显示，从C4 - C5至C7 - T1水平存在假性脊膜膨出，提示臂丛神经断裂，这支持了与TSEH相关的颈神经根撕脱伤的存在。颈丛综合征需要全面的诊断性检查。SEH应被视为神经根撕脱伤和臂丛综合征的一个病因。我们认为，SEH延伸至椎间孔可能是与神经根撕脱伤相关的一个影像学征象。
