Complete motor recovery after acute paraparesis caused by spontaneous spinal epidural hematoma: case report

<p>Abstract</p> <p>Background</p> <p>Spontaneous spinal epidural hematoma is a relatively rare but potentially disabling disease. Prompt timely surgical management may promote recovery even in severe cases.</p> <p>Case presentation</p> <p>We report a 34-year-old man with a 2-hour history of sudden severe back pain, followed by weakness and numbness over the bilateral lower limbs, progressing to intense paraparesis and anesthesia. A spinal magnetic resonance imaging scan was performed and revealed an anterior epidural hematoma of the thoracic spine. He underwent an emergency decompression laminectomy of the thoracic spine and hematoma evacuation. Just after surgery, his lower extremity movements improved. After 1 week, there was no residual weakness and ambulation without assistance was resumed, with residual paresthesia on the plantar face of both feet. After 5 months, no residual symptoms persisted.</p> <p>Conclusions</p> <p>The diagnosis of spontaneous spinal epidural hematoma must be kept in mind in cases of sudden back pain with symptoms of spinal cord compression. Early recognition, accurate diagnosis and prompt surgical treatment may result in significant improvement even in severe cases.</p

Change in Cerebral Perfusion Detected by Dynamic Susceptibility Contrast Magnetic Resonance Imaging Normal volunteers examined during normal breathing and hyperventilation

Cerebral perfusion parameters were measured using dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) in eight healthy volunteers examined during normal breathing and spontaneous hyperventilation. DSC-MRI-based cerebral blood flow (CBF) decreased during hyperventilation in all volunteers (average decrease 29%), and the corresponding global CBF estimates were 73 +/- 19 ml/(min 100g) during normal breathing and 52 +/- 7.9 ml/(min 100g) during hyperventilation (mean +/- SD, n=8). Furthermore, the hypocapnic conditions induced by hyperventilation resulted in a prolongation of the mean transit time (MTT) by on average 13%. The observed CBF estimates appeared to be systematically overestimated, in accordance with previously published DSC-MRI results, but reduced to more reasonable levels when a previously retrieved calibration factor was applied