Extruded disc causes acute cervical epidural hematoma and cord compression: a case report

Spinal Cord Series and Cases, 2021 · DOI: https://doi.org/10.1038/s41394-021-00403-8 · Published: April 27, 2021

Spinal Cord Injury Surgery Research Methodology & Design

Simple Explanation

A rare case is presented where a 65-year-old male experienced acute neurological decline due to a cervical disc extrusion causing an epidural hematoma. The patient, who had pre-existing cervical myelopathy, suffered a sudden worsening of symptoms, including right leg plegia, which was found to be caused by a hemorrhage due to the extruded disc. Prompt surgical intervention led to significant improvement in the patient's neurological status, highlighting the importance of recognizing and addressing this unique presentation quickly.

Study Duration

Not specified

Participants

One 65-year-old male

Evidence Level

Level 4: Case Report

Key Findings

1
Cervical disc extrusion can lead to venous damage, epidural hematoma, and spinal cord compression.
2
The case underscores the importance of re-imaging the spine after acute neurological changes, even in patients with known cervical myelopathy, to guide surgical management.
3
Early recognition and timely intervention can lead to positive patient outcomes in cases of cervical epidural hematoma caused by disc extrusion.

Research Summary

This case report presents a rare instance of acute cervical epidural hematoma caused by a herniated intervertebral disc in a 65-year-old male with pre-existing cervical myelopathy. The patient experienced a rapid neurological decline, including right leg plegia, which was attributed to an epidural hemorrhage resulting from the disc extrusion. Emergent surgical decompression and stabilization led to significant neurological improvement, emphasizing the importance of prompt diagnosis and intervention in such cases.

Practical Implications

Diagnostic Awareness

Clinicians should consider epidural hematoma secondary to disc herniation in patients presenting with acute neurological deterioration, even in those with known cervical myelopathy.

Imaging Importance

Re-imaging of the spine is crucial in cases of acute neurological changes to identify potential epidural hemorrhage and guide appropriate surgical management.

Surgical Intervention

Prompt surgical decompression and stabilization can lead to significant neurological improvement in patients with cervical epidural hematoma caused by disc extrusion.

Study Limitations

1
Single case report limits generalizability.
2
Specific mechanism of venous rupture not definitively proven.
3
Patient had pre-existing cervical myelopathy, which may influence the presentation and outcome.

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