A case of spontaneous spinal epidural hematoma mimicking stroke

Abstract

Spontaneous spinal epidural hematoma is an uncommon cause of acute non-traumatic myelopathy and may present with various clinical phenotypes. It should be included in the differential diagnosis of the patients who have focal neurological findings suggestive of stroke. Therefore, a thorough documentation of patient history is of great importance, since this can reveal symptoms suggestive of a different etiology. Here, we present a case of a 80-year-old female who was admitted with hemiparesis without cortical or cranial neurological abnormalities. She described pre-existing shoulder and neck pain. Diagnosis of epidural hematoma was made by cervical magnetic resonance imaging. Symptoms resolved partially after surgical intervention. Our case illustrates the variation in the clinical presentations of spontaneous spinal epidural hematoma which can be misdiagnosed as stroke. Therefore, in patients with preceding neck, shoulder or interscapular pain and focal neurological deficits, this diagnosis should be included in the differential diagnosis, particularly in the absence of cortical and cranial symptoms.