CONTEXT: Acute hemiparesis is a common initial presentation of ischemic stroke. Although hemiparesis due to spontaneous spinal epidural hematoma (SSEH) is an uncommon symptom, a few cases have been reported and misdiagnosed as cerebral infarction. DESIGN: Case reports of SSEH with acute hemiparesis. FINDINGS: In these two cases, acute stroke was suspected initially and administration of intravenous alteplase therapy was considered. In one case, the presentation was neck pain and in the other case, it was Lhermitte's sign; brain magnetic resonance imaging (MRI) and magnetic resonance angiography were negative for signs of ischemic infarction, hemorrhage, or arterial dissection. Cervical MRI was performed and demonstrated SSEH. CONCLUSION: Clinicians who perform intravenous thrombolytic treatment with alteplase need to be aware of this possible contraindication.
CONTEXT: Acute hemiparesis is a common initial presentation of ischemic stroke. Although hemiparesis due to spontaneous spinal epidural hematoma (SSEH) is an uncommon symptom, a few cases have been reported and misdiagnosed as cerebral infarction. DESIGN: Case reports of SSEH with acute hemiparesis. FINDINGS: In these two cases, acute stroke was suspected initially and administration of intravenous alteplase therapy was considered. In one case, the presentation was neck pain and in the other case, it was Lhermitte's sign; brain magnetic resonance imaging (MRI) and magnetic resonance angiography were negative for signs of ischemic infarction, hemorrhage, or arterial dissection. Cervical MRI was performed and demonstrated SSEH. CONCLUSION: Clinicians who perform intravenous thrombolytic treatment with alteplase need to be aware of this possible contraindication.
Authors: Julio A Chalela; Chelsea S Kidwell; Lauren M Nentwich; Marie Luby; John A Butman; Andrew M Demchuk; Michael D Hill; Nicholas Patronas; Lawrence Latour; Steven Warach Journal: Lancet Date: 2007-01-27 Impact factor: 79.321
Authors: Werner Hacke; Markku Kaste; Erich Bluhmki; Miroslav Brozman; Antoni Dávalos; Donata Guidetti; Vincent Larrue; Kennedy R Lees; Zakaria Medeghri; Thomas Machnig; Dietmar Schneider; Rüdiger von Kummer; Nils Wahlgren; Danilo Toni Journal: N Engl J Med Date: 2008-09-25 Impact factor: 91.245
Authors: Christian Fisahn; Marc D Moisi; Shiveindra Jeyamohan; Mary Wingerson; R Shane Tubbs; Charles Cobbs; Rod J Oskouian; Jens R Chapman Journal: Int J Surg Case Rep Date: 2016-09-29