TRANSIENT NEUROLOGICAL MANIFESTATIONS REV EALING SPONTANEOUS ACUTE EPIDURAL BRAIN HEMATOMAS

Spontaneous cervical epidural hematomas are uncommon lesions that usua lly produce permanent neurological deficit unless there is early surgi cal decompression. They are now well-recognized by scan X and especial ly by sagittal MRI oi the spine. We describe 2 patients, a 24 year-old man and a 79 year-old woman with no previous history of trauma who we re admitted in emergency for a sudden weakness of limbs, respectively a tetraplegia and a right hemiplegia. Both patients complained of inau gural and acute neck pain. Motor deficit completely resolved in few ho urs and MRI of the spine showed on T1 a signal isointense, extending r espectively from C3 to C6 and C5 to C7, consistent with an hematoma. L aboratory data and angiography were normal. Surgery was recused. Neck pain lasted about a week. Follow-up MRI, in one case, was normal two m onths later. Cervical epidural hematomas revealed by transient neurolo gical findings that completely and permanently resolved are exceptiona l. They could mimick ischemic myelopathy and should be considered in t he differential diagnosis of other painful vascular conditions like sy mptomatic vertebral dissection to avoid inappropriate anticoagulation. Conservative management in these cases may be proposed if spontaneous neurological resolution is confirmed by MRI.