Chronic Cervicothoracic Extradural Hematoma Presenting With Progressive Neck Flexion Deformity in an Adolescent: A Rare Case Report
DOI:
https://doi.org/10.46900/apn.v8i1.328Keywords:
Spinal epidural hematoma, Cervical spine, Spontaneous hematoma, Spinal cord compression, AdolescentAbstract
Background: Spinal epidural hematomas (SEHs) are rare but potentially a fatal cause of spinal cord compression. This report describes a case of chronic cervicothoracic SEH presenting with progressive neck flexion deformity.
Case presentation: We present a 16-year-old girl with a 5-month history of progressive neck pain, flexion deformity, and features of myeloradiculopathy. Neurologic examination revealed hyperreflexia (3+), bilateral extensor plantar responses, diminished right grip strength, right-sided limb weakness (4/5 power) and spastic gait. Magnetic resonance imaging (MRI) showed a C6-D1 epidural collection with T1 hypointensity and T2 hyperintensity causing spinal cord compression. She underwent C5–D1 laminectomy with complete hematoma evacuation. Following complete evacuation of the hematoma and excision of this sac-like epidural layer, a second true dural mater was visualized. Histopathology confirmed chronic hematoma with sac like epidural layer with neovascularization and fibrous membrane formation. Postoperatively, the patient achieved complete neurological recovery (5/5 power and normal bilateral grip strength) with no recurrence at six months follow up.
Conclusion: Chronic cervicothoracic SEH should be considered in adolescents presenting with progressive neck pain, deformity, and myeloradiculopathy, even without trauma. Identification of a hematoma membrane resembling dual dura suggests chronic SEH features and is important for achieving complete evacuation. Prompt MRI evaluation, and timely surgical decompression can achieve complete neurological recovery.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Prakash S Mahantshetti, Nikhita Kalyanshetti, Chandan Miriyala
This work is licensed under a Creative Commons Attribution 4.0 International License.
When publishing in Archives of Pediatric Neurosurgery journal, authors retain the copyright of their article and agree to license their work using a Creative Commons Attribution 4.0 International Public License (CC BY 4.0), thereby accepting the terms and conditions of this license (https://creativecommons.org/licenses/by/4.0/legalcode).
The CC BY 4.0 license terms applies to both readers and the publisher and allows them to: share (copy and redistribute in any medium or format) and adapt (remix, transform, and build upon) the article for any purpose, even commercially, provided that appropriate credit is given to the authors and the journal in which the article was published.
Authors grant Archives of Pediatric Neurosurgery the right to first publish the article and identify itself as the original publisher. Under the terms of the CC BY 4.0 license, authors allow the journal to distribute the article in third party databases, as long as its original authors and citation details are identified.
