Spontaneous hemorrhage of spinal epidural capillary hemangioma resulting in hyperacute neurologic deficit

Medicine, 2023 · DOI: http://dx.doi.org/10.1097/MD.0000000000035606 · Published: October 20, 2023

Simple Explanation

This case report describes a rare spinal tumor in a teenage girl that caused sudden paralysis. The tumor, a capillary hemangioma, bled unexpectedly, leading to rapid loss of movement and sensation. Doctors performed surgery to remove the tumor, and the patient surprisingly regained full function within a couple of months. This highlights the potential for recovery even after severe spinal cord problems in young patients. The report suggests that quick surgical intervention can lead to positive outcomes in similar cases, emphasizing the importance of considering such tumors in diagnoses of spinal issues, especially in younger individuals.

Study Duration

Not specified

Participants

A 16-year-old female

Evidence Level

Level 4, Case Report

Key Findings

1
The patient presented with hyperacute neurologic deficit, progressing within an hour to paraplegia and loss of sensation up to the breasts, due to spontaneous hemorrhage of a spinal epidural capillary hemangioma (SECH).
2
Emergent MRI revealed a dumbbell-shaped epidural mass at the T1–T2 level, which was surgically removed 16 hours after paralysis.
3
The patient achieved complete neurological recovery within 2 months post-surgery, suggesting favorable prognosis with immediate surgical intervention, especially in younger patients.

Research Summary

This case report details a rare instance of spontaneous hemorrhage in a spinal epidural capillary hemangioma (SECH) in a 16-year-old female, resulting in hyperacute neurologic deficit. Surgical intervention, though performed 16 hours after paralysis, led to complete neurological recovery within two months, underscoring the importance of prompt diagnosis via MRI and immediate surgical management. The case contributes to the limited literature on SECH and suggests that younger patients may experience better neurological outcomes following surgical decompression for spinal cord injuries.

Practical Implications

Early Diagnosis

Prompt MRI diagnosis is crucial for identifying epidural lesions with dumbbell-shaped appearance, especially at the thoracic level.

Surgical Intervention

Immediate surgical intervention for SECH can result in favorable prognosis, especially in younger patients.

Age Factor

Younger age may be a factor in better neurological improvement after spinal cord injury, warranting further investigation.

Study Limitations

1
Single case report limits generalizability.
2
Delayed surgery (16 hours post-paralysis) complicates assessment of optimal intervention timing.
3
Lack of a control group prevents definitive conclusions about the efficacy of specific treatments.

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