6533b824fe1ef96bd12801d1

RESEARCH PRODUCT

Traumatic lumbar disc extrusion mimicking spinal epidural hematoma: Case report and literature review

Maria Angela PinoSilvana TumbioloLara BrunassoDomenico Gerardo IacopinoLuigi BasileRosa Maria GerardiFrancesca GrazianoCarlo GulìRosario MaugeriGiovanni Federico Nicoletti

subject

medicine.medical_specialtymedicine.medical_treatmentCase Report030218 nuclear medicine & medical imagingLaminotomyLesion03 medical and health sciencesLumbar disc0302 clinical medicineLumbarEpidural hematomaMagnetic resonance imagingSpinal epidural hematomamedicineExtruded disc herniation Magnetic resonance imaging Spinal epidural hematoma Traumatic disc extrusionExtruded disc herniationmedicine.diagnostic_testSettore MED/27 - Neurochirurgiabusiness.industryMagnetic resonance imagingmedicine.diseaseTraumatic disc extrusioncardiovascular systemSurgeryNeurology (clinical)Radiologymedicine.symptomPresentation (obstetrics)businessSpinal epidural hematoma030217 neurology & neurosurgery

description

Background: Because the neurological presentation of spinal epidural hematomas (SEH) is often not specific, they may be misdiagnosed as acute lumbar disk herniations. Here, we present a case in which a traumatic disc extrusion mimicked an epidural hematoma and reviewed the appropriate literature. Case Description: A 27-year-old male sustained a high-energy fall. The lumbar MRI scan showed a L4-S1 ventral medium/high signal intensity mass on the T1- and high signal intensity lesion on T2-weighted images; the original diagnosis was spinal epidural hematoma. However, at surgery, consisting of a left L4 and L5 hemilaminectomy with L4-L5 and L5-S1 laminotomy, an extruded lumbar disc was encountered at the L4-L5 level and removed; no additional pathology or SEH was found at either level. Conclusion: On MR, SEH may mimic acute lumbar disk herniations. Depending on the clinical symptoms/signs, surgical intervention will both correctly confirm the diagnosis and relieve neural compression.

10.25259/sni_407_2020http://europepmc.org/articles/PMC7656023