Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities
Introduction: Spontaneous spinal epidural hematomas (SSEHs) are rare in childhood, especially in infants. Case Report: We present the case of a 17-month-old-boy with trisomy 21 and a large SSEH. He was hospitalized for acute onset paraplegia after 6 days of irritability. Nine days after symptom onse...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Japanese Society for Spine Surgery and Related Research
2018-10-01
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| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/2/4/2_2017-0085/_pdf/-char/en |
| _version_ | 1819026160921608192 |
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| author | Manabu Mukai Masayuki Miyagi Tomohisa Koyama Takayuki Imura Kuniaki Nakahara Toshiyuki Nakazawa Gen Inoue Wataru Saito Eiki Shirasawa Kentaro Uchida Masashi Takaso |
| author_facet | Manabu Mukai Masayuki Miyagi Tomohisa Koyama Takayuki Imura Kuniaki Nakahara Toshiyuki Nakazawa Gen Inoue Wataru Saito Eiki Shirasawa Kentaro Uchida Masashi Takaso |
| author_sort | Manabu Mukai |
| collection | DOAJ |
| description | Introduction: Spontaneous spinal epidural hematomas (SSEHs) are rare in childhood, especially in infants.
Case Report: We present the case of a 17-month-old-boy with trisomy 21 and a large SSEH. He was hospitalized for acute onset paraplegia after 6 days of irritability. Nine days after symptom onset, magnetic resonance imaging (MRI) of the spine revealed an extensive epidural hematoma between C7 and T5 causing severe spinal cord compression. After a coagulation disorder was ruled out (12 days after onset), he underwent emergency hemilaminectomy with evacuation of the hematoma. His neurologic impairment gradually improved, and 4 months after surgery he was back to his neurologic baseline. At 18 months after surgery, he was walking independently, although he had some developmental disabilities due to trisomy 21.
Conclusions: Only 20 cases of SSEH in infancy have been previously reported, and this is the first report of SSEH in an infant with developmental disabilities. Because of the non-specific symptoms and difficulty obtaining MRIs in infants, particularly in those with developmental disabilities, the diagnosis and treatment of SSEH may be delayed. However, early diagnosis with MRI and early evacuation of SSEH in patients with severe neurological impairments is important for good outcomes. Attention must be paid to postoperative spinal deformity in infants. |
| first_indexed | 2024-12-21T05:22:10Z |
| format | Article |
| id | doaj.art-abf0dceb7df441bab7801d5db3347489 |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-12-21T05:22:10Z |
| publishDate | 2018-10-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-abf0dceb7df441bab7801d5db33474892022-12-21T19:14:48ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2018-10-012433533910.22603/ssrr.2017-00852017-0085Spontaneous Spinal Epidural Hematoma in an Infant with Developmental DisabilitiesManabu Mukai0Masayuki Miyagi1Tomohisa Koyama2Takayuki Imura3Kuniaki Nakahara4Toshiyuki Nakazawa5Gen Inoue6Wataru Saito7Eiki Shirasawa8Kentaro Uchida9Masashi Takaso10Department of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityIntroduction: Spontaneous spinal epidural hematomas (SSEHs) are rare in childhood, especially in infants. Case Report: We present the case of a 17-month-old-boy with trisomy 21 and a large SSEH. He was hospitalized for acute onset paraplegia after 6 days of irritability. Nine days after symptom onset, magnetic resonance imaging (MRI) of the spine revealed an extensive epidural hematoma between C7 and T5 causing severe spinal cord compression. After a coagulation disorder was ruled out (12 days after onset), he underwent emergency hemilaminectomy with evacuation of the hematoma. His neurologic impairment gradually improved, and 4 months after surgery he was back to his neurologic baseline. At 18 months after surgery, he was walking independently, although he had some developmental disabilities due to trisomy 21. Conclusions: Only 20 cases of SSEH in infancy have been previously reported, and this is the first report of SSEH in an infant with developmental disabilities. Because of the non-specific symptoms and difficulty obtaining MRIs in infants, particularly in those with developmental disabilities, the diagnosis and treatment of SSEH may be delayed. However, early diagnosis with MRI and early evacuation of SSEH in patients with severe neurological impairments is important for good outcomes. Attention must be paid to postoperative spinal deformity in infants.https://www.jstage.jst.go.jp/article/ssrr/2/4/2_2017-0085/_pdf/-char/enSpontaneous spinal epidural hematomasInfantDevelopmental disability |
| spellingShingle | Manabu Mukai Masayuki Miyagi Tomohisa Koyama Takayuki Imura Kuniaki Nakahara Toshiyuki Nakazawa Gen Inoue Wataru Saito Eiki Shirasawa Kentaro Uchida Masashi Takaso Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities Spine Surgery and Related Research Spontaneous spinal epidural hematomas Infant Developmental disability |
| title | Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities |
| title_full | Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities |
| title_fullStr | Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities |
| title_full_unstemmed | Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities |
| title_short | Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities |
| title_sort | spontaneous spinal epidural hematoma in an infant with developmental disabilities |
| topic | Spontaneous spinal epidural hematomas Infant Developmental disability |
| url | https://www.jstage.jst.go.jp/article/ssrr/2/4/2_2017-0085/_pdf/-char/en |
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