A case of spontaneous cervical epidural hematoma associated with cervical spondylosis

A case of spontaneous cervical epidural hematoma associated with long-term cervical spondylosis is presented. A 69-year-old man was admitted with a 3-day history of sudden onset of severe neck pain radiating to both upper extremities followed by impossibility in standing. Neurological examination on admission revealed paralysis below C7, total anesthesia below the T4 level and urinary incontinence. Initially, he was diagnosed as cervical cord injury caused by a violent fall. Subsequently, skeletal traction with tongs of the Crutchfield design was carried out. Nevertheless, he developed spinal shock 6 days after admission. A metrizamide myelogram followed by CT scanning 5 days after admission demonstrated an extradural isodensity mass displacing dura forward. The mass lesion was confirmed as spontaneous epidural hematoma by laminectomy from C4 to C7. Sudden onset of neck pain with radiation into both upper extremities should be differentiated cervical epidural hematoma from other cervical spinal lesions. Metrizamide CT is helpful to diagnose cervical epidural hematoma.