Acute epidural hematoma due to spinal venous angioma: A case report

Background: Spinal epidural cavernous angioma was reported about 4% of all spinal epidural tumors, mostly generating as a primary lesion in the vertebral bone. Spinal epidural hematoma (SEDH) due to angioma without primary origin was very rare, which reported in the English literatures was only 10 cases including our case. The main symptoms were numbness and pains and motor weakness owing to the acute compression signs of cord and roots. Emergency surgical treatment was required for the good surgical results. We present a rare case of cervical acute epidural hematoma due to ruptured venous angioma. Case presentation: A 78-year-old man, who suffered from sudden severe right suboccipitalgia., and sent to our hospital. He also noticed progressive numbness and motor weakness over his bilateral upper and lower extremities after the onset. Cervical CT and MRI showed acute intracanal hematoma over the right side of the cervical spine at C2 to C6. Emergency operation was performed 13 h after the onset. His sensory and motor symptoms were disappeared quickly after the operation. Pathological examination revealed spinal epidural hematoma due to venous angioma. Conclusion: This case presented with acute progressive deterioration of paresis and sensory disturbance, and required emergency operation. Early diagnosis and emergency surgical treatment are essential for the therapy of acute spinal epidural hematoma due to venous angioma

Acute epidural hematoma due to spinal venous angioma: A case report

Background: Spinal epidural cavernous angioma was reported about 4% of all spinal epidural tumors, mostly generating as a primary lesion in the vertebral bone. Spinal epidural hematoma (SEDH) due to angioma without primary origin was very rare, which reported in the English literatures was only 10 cases including our case. The main symptoms were numbness and pains and motor weakness owing to the acute compression signs of cord and roots. Emergency surgical treatment was required for the good surgical results.We present a rare case of cervical acute epidural hematoma due to ruptured venous angioma. Case presentation: A 78-year-old man, who suffered from sudden severe right suboccipitalgia., and sent to our hospital. He also noticed progressive numbness and motor weakness over his bilateral upper and lower extremities after the onset. Cervical CT and MRI showed acute intracanal hematoma over the right side of the cervical spine at C2 to C6. Emergency operation was performed 13h after the onset. His sensory and motor symptoms were disappeared quickly after the operation. Pathological examination revealed spinal epidural hematoma due to venous angioma. Conclusion: This case presented with acute progressive deterioration of paresis and sensory disturbance, and required emergency operation. Early diagnosis and emergency surgical treatment are essential for the therapy of acute spinal epidural hematoma due to venous angioma. Keywords: Acute spinal epidural hematoma, Venous angioma, Surgical treatmen

The Significance of Ear Plugging in Localization-related Epilepsy

Purpose: The localizing value of ear plugging in the treatment of auditory onset partial seizures, to our knowledge, has not been previously described. We propose that ear plugging is a clinical response to a sensory seizure manifested as an auditory hallucination and a tool for identifying the seizure focus in the auditory cortex on the superior temporal gyrus. Methods: We report on three children who had prior epilepsy surgery for recurrent symptomatic localization-related epilepsy and who, subsequent to their surgery, displayed stereotyped unilateral or bilateral ear plugging at the onset of partial seizures. We studied scalp video electroencephalography (VEEG), magnetoencephalography (MEG), and magnetic resonance imaging (MRI) in all three. Additionally, we used electrocorticography (ECoG) in two patients, intracranial VEEG monitoring in one patient, and functional MRI language mapping in two patients. Results: All three patients plugged their ears with their hands during auditory auras that localized to the superior temporal gyrus and were followed by partial seizures that spread to a wider field, as shown on scalp and intracranial VEEG. All three patients had MEG interictal discharges in the superior temporal gyrus. One patient who was nonverbal and unable to describe an auditory phenomenon plugged the ear contralateral to where temporal lobe-onset seizures and MEG interictal discharges occurred. Conclusions: Ear-plugging seizures indicate an auditory aura and may also lateralize seizure onset to the contralateral temporal lobe auditory cortex. Stereotyped behaviors accompanied by epileptic seizures in children who have poor communication skills are important in the seizure semiology of localization-related epilepsy