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Mine-Ok Chang, Eun Sil Koh, Min Ju Kim, Yoon Sik Chang, Sungjin Chung, Spontaneous spinal epidural hematoma, QJM: An International Journal of Medicine, Volume 105, Issue 7, July 2012, Pages 705–706, https://doi.org/10.1093/qjmed/hcr097
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A 32-year-old woman was referred to our hospital with the sudden onset of low back and cervical pain during a hemodialysis session at a local hospital. She had been on hemodialysis because of progressive renal failure due to lupus nephritis. There were no external signs of trauma on physical examination. A few hours after admission quadriplegia developed. A cervical MRI showed a posterior epidural lesion which had intermediate signal intensity on T1-weighted images (Figure 1A) and high-signal intensity on T2-weighted images (Figure 1B) between the C2 and T2 levels, which was suggestive of a recent epidural hematoma with edema in the spinal cord. The patient underwent an immediate C3–C7 hemi-laminectomy with removal of an epidural hematoma. Despite the slight improvement in motor function after the decompression, the patient developed pneumonia with subsequent sepsis and died 5 weeks after admission.
One of extremely rare neurological manifestations in patients with systemic lupus erythematosus (SLE) is spontaneous spinal epidural hematoma (SSEH), which is usually associated with a poor outcome.1,2 The pathogenic mechanism to explain the association between SLE and SSEH has not yet been determined.1 The clinicians should be aware of this rare but serious complication in patients who have systemic autoimmune disorders.
