TITLE:
Spontaneous Cervical Epidural Hematoma Mimicking Stroke: A New Perspective on Diagnosis and Treatment
AUTHORS:
Alp Yurter, Paul E. Kaloostian
KEYWORDS:
Tissue Plasminogen Activator (TPA); Stroke Mimic; Spontaneous Spinal Epidural Hematoma; Cervical
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.3 No.4,
October
15,
2013
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.