MISDIAGNOSIS OF SPONTANEOUS SPINAL EPIDURAL HEMATOMA IN A PARTURIENT: A CASE REPORT

Background: Spontaneous spinal epidural hematomais a rare clinical entity. The symptoms can be similar to Guillain Barre Syndrome, especially if it occurs at the cervicothoracic junction. Its pathophysiology is still unknown and seems to be multifactorial, which makes it a challenging situation in terms of diagnosis and treatment, mainly during pregnancy.

Case report:a 22-year-old female at 31 weeks of pregnancy presented to the emergencies complaining of the sudden onset of a neurogenic syndrome with the history of influenza like symptoms six days before. Although cerebrospinal fluid analysis showed no abnormalities, the diagnosis of Guillain Barre Syndrome was suspected on the basis of a series of arguments.The next day, her case worsened as she started exhibiting tetraparesis with genital disorders. Emergency Magnetic Resonance Imaging showed a spinal epidural hematoma extending from C5 to C7. The patient underwent an emergency decompressive laminectomy with evacuation of the hematoma. No apparent vascular malformation was objectified. Despite rehabilitation, she still experienced motor sequelae.

Conclusion:Each case requires individual and repetitive evaluation with the establishment of a dated diagram in order to minimize the risk of delayed diagnosis and treatment in spontaneous spinal epidural hematoma, mainly during pregnancy.