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This version was published on May 1, 2008
Journal of Child Neurology, Vol. 23, No. 5, 564-567 (2008)
DOI: 10.1177/0883073807309777
© 2008 SAGE Publications

Spontaneous Spinal Epidural Hematomas in Children: Can We Prevent a Negative Prognosis?—Reflections on 2 Cases

Gian Paolo Ramelli, MD

Department of Pediatrics, Ospedale San Giovanni, Bellinzona, Hopitaux Universitaires, gianpaolo.ramelli{at}eoc.ch

Duccio Boscherini, MD

Department of Neurosurgery, Ospedale Civico, Lugano, Hopitaux Universitaires

Pierre Kehrli, MD

Department of Neurosurgery, CHU Hautepierre, Strasbourg, France

Benedict Rilliet, MD

Department of Neurosurgery, Hôpitaux Universitaires, CH-1211, Geneve Switzerland

Spontaneous spinal epidural hematomas in children are very rare and, until now, have not been described in infants. Spontaneous spinal epidural hematomas is characterized by a sudden onset of acute back pain followed by acute neurological deterioration within a few hours, but in younger children the initial symptoms are often nonspecific, leading to a delay in diagnosis and treatment. Although some cases have been reported, controversy persists as to its origin, diagnosis, and timing of treatment. We present 2 new cases of this rare condition: a 7-month-old girl who suffered from acute paraplegia and, unfortunately, did not recover after adequate spinal decompression. To our knowledge, this is the first reported case of spontaneous spinal epidural hematomas in an infant. We also report a similar observation in a 13.5-year-old boy who also suffered from acute paraplegia and had only a partial recovery after urgent decompression.

Key Words: spontaneous epidural hematoma • spinal cord


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