Spontaneous Cervical Epidural Hematoma Mimicking Stroke: A New Perspective on Diagnosis and Treatment

Alp Yurter, Paul E. Kaloostian

Johns Hopkins University Medical Center, Baltimore, USA.

DOI: 10.4236/ojmn.2013.34013                

Abstract

Objective: The authors report an extremely rare case of stroke-mimicking, spontaneous cervical epidural hematoma treated with tissue plasminogen activator (TPA). Case Report: We report the case of a 69-year-old female presenting with left-sided hemiparesis of the arm and leg. She was administered by TPA because she was thought to have an ischemic stroke and intracranial CT showed no hemorrhage. However, her neurological condition continued to decline, and MRI of her cervical spine revealed a large spontaneous epidural hematoma. Subsequently, the patient underwent emergency surgery. Conclusions: TPA administration to spinal epidural hematoma (SEH) patients is dangerous. Because cervical epidural hematomas can mimic stroke, the attending medical staff needs to exercise vigilance in diagnosis. In addition to the head, the spine should also be scanned prior to TPA administration.

Keywords

Tissue Plasminogen Activator (TPA); Stroke Mimic; Spontaneous Spinal Epidural Hematoma; Cervical

Conflicts of Interest

The authors declare no conflicts of interest.

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