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• Vol.45 No.9
• CLINICA NEUROL, 45: 652−656, 2005
• Vol.45 No.9 contents

Case Report

A case of acute cervical epidural hematoma mimicking medial medullary infarction complicated by arterial dissection

Masahiro Yasaka, M.D., Shoji Arihiro, M.D., Yasuhiro Hasegawa, M.D. and Kazuo Minematsu, M.D.

Cerebrovascular Division, Department of Medicine, National Cardiovascular Center

A 67-year woman with hypertension rapidly noted weakness of the right upper and lower extremities with posterior cervical pain. At admission to our hospital, she showed right hemiparesis without facial palsy, and bilateral pathological reflex. Chest X-ray demonstrated enlargement of the mediastinal shadow. We suspected that she developed aortic arch dissection extending into the vertebral arteries and subsequent medial medullary infarction. However, enhanced thoracic CT, brain MRI-DWI and MRA examinations were negative. Her symptoms rapidly recovered three hours after the onset. A cervical MRI study revealed cervical epidural hematoma locating between the C3 and C6, which suppressed right side of the spinal cord. In conclusion, cervical epidural hematoma as well as medial medullary infarction complicated by the vertebral arterial dissection should be urgently explored when a patient had a sudden onset of cervical pain and hemiparesis without facial palsy.

(CLINICA NEUROL, 45: 652−656, 2005)
key words: cervical epidural hematoma, medial medullary infarction, arterial dissection

(Received: 28-Oct-04)