Torticollis and right arm weakness due to atraumatic spinal epidural hematoma in a 5-year-old girl child

Authors

  • Esam E. Barnawi Department of Pediatric Emergency, King Fahad Medical City, Riyadh, Saudi Arabia
  • Altaf Ahmad Bhat Department of Pediatric Emergency, King Fahad Medical City, Riyadh, Saudi Arabia
  • Abdullatif Almalki Department of Pediatric Emergency, King Fahad Medical City, Riyadh, Saudi Arabia
  • Nada Daud Bin Daud Department of Pediatric Emergency, King Fahad Medical City, Riyadh, Saudi Arabia
  • Mohammad Abdullah Almazeedi Department of Pediatric Emergency, King Fahad Medical City, Riyadh, Saudi Arabia
  • Abdulelah Ahmad Ali Al Amri Department of Pediatric Emergency, King Fahad Medical City, Riyadh, Saudi Arabia

DOI:

https://doi.org/10.18203/2349-3291.ijcp20241371

Keywords:

Torticollis, Right arm weakness, Spontaneous spinal epidural hematoma pediatric, Neurological emergency

Abstract

Spontaneous spinal epidural hematoma (SEH) is a rare presentation as cause of neurological weakness in children and is neurological emergency. The most commonly affected site in children is cardiothoracic region. Early management is associated with better functional outcomes. We report a 5-year-old girl who presented with long standing neck pain now presenting to emergency with torticollis and right arm weakness around shoulder joint. Magnetic resonance imaging of C-spine revealed posterior epidural hematoma that extend from C3/C4 level down to C6/C7 level, it is causing moderate spinal canal stenosis and mass-effect on the spinal cord, with mild intramedullary abnormal T2 signal intensity indicating myelomalacia. There were no predisposing factors in our patient. Epidural hematoma was drained surgically and post-surgery patient started showing neurological recovery on follow. Cases of spontaneous SEH have been reported in infants as well and the clinical features in children are often nonspecific leading to a delay in diagnosis.  This case report aims to raise awareness about this neurological emergency, in which early intervention is crucial.

 

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Published

2024-05-27

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Section

Case Reports