Cervical epidural hematoma: a case series highlighting uncommon causes
Dublin Core
Title
Cervical epidural hematoma: a case series highlighting uncommon causes
Subject
Spinal epidural hematoma, Neck strain, Acupuncture, Hemiparalysis, Decompression
Description
Abstract
Background Cervical epidural hematoma (CEH) is a rare but potentially devastating condition, characterized by
the accumulation of blood within the epidural space of the cervical spine, leading to spinal cord compression
(Perron AD, Huff JS. Spinal cord disorders. In: Marx JA, et al. editors. Rosen’s emergency medicine: concepts and
clinical practice. 8th ed. Philadelphia: Saunders; 2013. pp. 1419–27.); (Raasck K, Habis AA, Aoude A, Simoes L, Barros F,
Reindl R. Spontaneous spinal epidural hematoma management: a case series and literature review. Spinal Cord Ser
Cases. 2017;3:16043. https://doi.org/10.1038/scsandc.2016.43.); (Ryo Yamamoto M, Ito H, Shimuzu K, Wakabayashi
H, Oyama. Two cases of cervical epidural hematoma presenting with left-sided hemiplegia and requiring surgical
drainage. Cureus. 2022;14(4):e23915. https://doi.org/10.7759/cureus.23915.). While trauma and iatrogenic causes
are well-documented, cases attributed to neck strain and acupuncture are uncommon. (Raasck K, Habis AA, Aoude
A, Simoes L, Barros F, Reindl R. Spontaneous spinal epidural hematoma management: a case series and literature
review. Spinal Cord Ser Cases. 2017;3:16043. https://doi.org/10.1038/scsandc.2016.43.); (Shiraishi S, Goto I, Kuroiwa Y,
Nishio S, Kinoshita K. Spinal cord injury as a complication of an acupuncture. Neurology. 1979;29(8):1188–90. https://
doi.org/10.1212/wnl.29.8.1188.) Here, we present two cases of CEH secondary to these unusual aetiologies. Both
cases highlight the importance of considering uncommon causes of CEH to ensure early recognition and prompt
treatment.
Case presentations Case 1 is an 81-year-old lady who presented with left hemiparesis and paraesthesia following a
fall with neck strain. Magnetic resonance imaging (MRI) of cervical spine revealed left C3-C7 epidural haematoma with
severe cord compression. In Case 2, a 35-year-old gentleman experienced sudden onset numbness and weakness in
all limbs just 10 minutes after receiving acupuncture. MRI showed an epidural hematoma at the C2-C4 levels. Both
patients underwent immediate surgical decompression and had significant recovery.
Conclusion Although CEH is a rare occurrence, it can potentially be a neurosurgical emergency. Physicians
must remain cognizant of the diverse aetiologies associated with CEH and the necessity for early recognition and
immediate treatment.
Keywords Spinal epidural hematoma, Neck strain, Acupuncture, Hemiparalysis, Decompression
Background Cervical epidural hematoma (CEH) is a rare but potentially devastating condition, characterized by
the accumulation of blood within the epidural space of the cervical spine, leading to spinal cord compression
(Perron AD, Huff JS. Spinal cord disorders. In: Marx JA, et al. editors. Rosen’s emergency medicine: concepts and
clinical practice. 8th ed. Philadelphia: Saunders; 2013. pp. 1419–27.); (Raasck K, Habis AA, Aoude A, Simoes L, Barros F,
Reindl R. Spontaneous spinal epidural hematoma management: a case series and literature review. Spinal Cord Ser
Cases. 2017;3:16043. https://doi.org/10.1038/scsandc.2016.43.); (Ryo Yamamoto M, Ito H, Shimuzu K, Wakabayashi
H, Oyama. Two cases of cervical epidural hematoma presenting with left-sided hemiplegia and requiring surgical
drainage. Cureus. 2022;14(4):e23915. https://doi.org/10.7759/cureus.23915.). While trauma and iatrogenic causes
are well-documented, cases attributed to neck strain and acupuncture are uncommon. (Raasck K, Habis AA, Aoude
A, Simoes L, Barros F, Reindl R. Spontaneous spinal epidural hematoma management: a case series and literature
review. Spinal Cord Ser Cases. 2017;3:16043. https://doi.org/10.1038/scsandc.2016.43.); (Shiraishi S, Goto I, Kuroiwa Y,
Nishio S, Kinoshita K. Spinal cord injury as a complication of an acupuncture. Neurology. 1979;29(8):1188–90. https://
doi.org/10.1212/wnl.29.8.1188.) Here, we present two cases of CEH secondary to these unusual aetiologies. Both
cases highlight the importance of considering uncommon causes of CEH to ensure early recognition and prompt
treatment.
Case presentations Case 1 is an 81-year-old lady who presented with left hemiparesis and paraesthesia following a
fall with neck strain. Magnetic resonance imaging (MRI) of cervical spine revealed left C3-C7 epidural haematoma with
severe cord compression. In Case 2, a 35-year-old gentleman experienced sudden onset numbness and weakness in
all limbs just 10 minutes after receiving acupuncture. MRI showed an epidural hematoma at the C2-C4 levels. Both
patients underwent immediate surgical decompression and had significant recovery.
Conclusion Although CEH is a rare occurrence, it can potentially be a neurosurgical emergency. Physicians
must remain cognizant of the diverse aetiologies associated with CEH and the necessity for early recognition and
immediate treatment.
Keywords Spinal epidural hematoma, Neck strain, Acupuncture, Hemiparalysis, Decompression
Creator
Wey Ting Lee1*, Joan Rui Shan Fun1
and Yi Wen Mathew Yeo1
and Yi Wen Mathew Yeo1
Source
https://doi.org/10.1186/s12245-024-00693-3
Date
2023
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Wey Ting Lee1*, Joan Rui Shan Fun1
and Yi Wen Mathew Yeo1, “Cervical epidural hematoma: a case series highlighting uncommon causes,” Repository Horizon University Indonesia, accessed April 25, 2026, https://repository.horizon.ac.id/items/show/12412.