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Calcific Discitis
Joseph Junewick, MD FACR
over 7 years ago
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Cervical Epidural Hematoma

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MR CT
Activities:
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History

10 year old pedestrian struck by truck.


Case Images


Diagnosis

Cervical Epidural Hematoma Related to Transient Craniocervical Dissociation

Clinical Notes

Epidural hemorrhage confirmed at surgery.

Findings

CT – Hyperdense extraaxial collection at the foramen magnum

MR – Sagittal IR and sagittal and axial T1 and T2 images of the cervical spine 1) confirm extraaxial hemorrhage at the foramen magnum which continues caudally in the epidural space and 2) show suboccipital and precervical edema. The parasagittal T2 images show fluid in the atlanto-occipital joints.

Discussion

Epidural hematoma is uncommon, occurring in fewer than 2% of cervical spine injuries. The cervical spine is the most common site of traumatic epidural hemorrhage and likely related to sudden increase in pressure within the epidural venous plexus. Cervical epidural hemorrhage is more common in younger patients probably related to increased elasticity of the spine and higher incidence of craniocervical injuries but can also be seen in patients with stiff spines (e.g., diffuse idiopathic skeletal hyperostosis).

Reference

Fountas KN, et al. Cervical epidural hematoma in children: A rare clinical entity. J Neurosurg 2006; 20(2):1-4.



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