Document Detail

Vertebral artery dissection as an extremely rare cause of spinal epidural hematoma: case report and review of the literature.
MedLine Citation:
PMID:  19247570     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To present a patient with a cervico-thoracic ventrally located epidural hematoma caused by dissection and subsequent bleeding of the cervical portion of the vertebral artery. SUMMARY AND BACKGROUND DATA: Non traumatic epidural hematoma is a rare entity. The etiology usually is not clarified: a venous origin is usually suspected although an arterial source is also possible. CLINICAL REPORT: A 32-year-old woman presented with a ventrally located cervico-thoracic epidural hematoma caused by non traumatic dissection and dissecting aneurysm rupture of the cervical portion of the vertebral artery. The dissection was demonstrated by magnetic resonance imaging and digital subtraction angiography. The patient had no neurological symptoms and was treated by conservative methods. Follow up imaging showed healing of the vertebral artery and resorption of the epidural hematoma. CONCLUSION: Dissection of the cervical portion of the vertebral artery with subsequent perivascular bleeding is not well recognized as a possible cause of a spinal epidural hematoma. Even though this entity and the underlying cause may be rare, we suggest a vigilant search for vertebral artery injury in cases of ventrally located cervical and upper thoracic epidural hematoma.
Zsolt Kulcsar; Zsolt Berentei; Miklos Marosfoi; Istvan Nyary; Istvan Szikora
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-02-28
Journal Detail:
Title:  Acta neurochirurgica     Volume:  151     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-13     Completed Date:  2010-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  1319-23     Citation Subset:  IM    
National Institute of Neurosurgery, Budapest, Hungary.
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MeSH Terms
Angiography, Digital Subtraction
Epidural Space / pathology*,  physiopathology
Foramen Magnum / pathology,  physiopathology
Hematoma, Epidural, Spinal / etiology*,  pathology*,  physiopathology
Magnetic Resonance Imaging
Spinal Canal / pathology,  physiopathology
Spinal Cord Compression / etiology,  pathology,  physiopathology
Thoracic Vertebrae / pathology,  physiopathology
Vertebral Artery / pathology*,  physiopathology,  radiography
Vertebral Artery Dissection / complications*,  pathology*,  physiopathology

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