Insidious onset of spontaneous spinal epidural hematoma in immune thrombocytopenic purpura: a case-based review.

Autor: Kim Y; Department of Neurosurgery, SUNY Upstate University Hospital, Syracuse, NY, USA., Koutsouras GW; Department of Neurosurgery, SUNY Upstate University Hospital, Syracuse, NY, USA. koutsoug@upstate.edu., Bourdages G; Department of Neurosurgery, SUNY Upstate University Hospital, Syracuse, NY, USA., Beutler T; Department of Neurosurgery, SUNY Upstate University Hospital, Syracuse, NY, USA.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2023 Jul; Vol. 39 (7), pp. 1903-1909. Date of Electronic Publication: 2023 May 01.
DOI: 10.1007/s00381-023-05963-8
Abstrakt: Introduction: Spontaneous spinal epidural hematoma (SSEH) can result from various etiologies with a variable degree of neurological deficits. Here, we describe a rare case of SEH secondary to immune thrombocytopenic purpura (ITP) in a child and review the literature of SSEH caused by ITP.
Case Report: A 9-year-old female who presented with rapid neurological decline, including bowel and bladder incontinence and paraparesis. A SSEH was observed extending from C2 to T6, causing a mass effect on the spinal cord. Her platelet count was only 7000/µL. Multidisciplinary care was established with neurosurgery, pediatric hematology, and pediatric surgery. The patient was managed emergently with splenectomy and surgical evacuation, with multilevel laminectomy and laminoplasty for evacuation of the hematoma. After a short course of rehabilitation, the patient regained all neurological function.
Conclusion: We report the first case of cervicothoracic SSEH secondary to ITP in a child managed with emergent splenectomy and surgical evacuation with multilevel lamoplasty. We also described the methods of timely diagnosis, urgent management, and overall prognosis of patients with this condition.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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