Turkish Neurosurgery 2009 , Vol 19 , Num 1
Spontaneous Cervical Epidural Hematoma Causing Brown-Sequard Syndrome: Case Report
Bakırkoy Hospital for Psychiatric and Neurological Diseases, 3. Neurosurgery Department, İstanbul, Turkey OBJECTIVE: Spontaneously occurring epidural hematoma without any identified etiology is a rare phenomenon. These are often neurosurgical emergencies; therefore, prompt diagnosis and treatment are paramount. Because of the rarity of this condition, we illustrated its presentation, evaluation and management in this recent case.

CASE: A 63-year-old male presented to our emergency room with right-sided hemiparesis and contralateral hypoesthesia, consistent with a C5 Brown-Sequard syndrome. An initial evaluation for cerebral infarction was unremarkable, including a negative brain computerized tomography imaging. Cervical magnetic resonance imaging (MRI) revealed a cervical epidural hematoma. The patient underwent emergent laminectomy for decompression and evacuation of the hematoma within 24 hours of presentation to the emergency room. The patient's symptoms improved remarkably after surgery and a 4th-month follow-up MRI evaluation was normal.

CONCLUSION: This report highlights the various presentations, evaluation, and management options for this rare diagnosis. It emphasizes the necessity of prompt diagnosis for possible emergent intervention. Keywords : Cervical epidural hematoma, Brown-Sequard syndrome, Spinal cord, Acute hemiparesis, Surgical treatment, Acute neck pain

Corresponding author : Ender Ofluoğlu, enderofluoglu@yahoo.com