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Neurology
Vertebral artery dissection as the underlying cause of ventral spinal epidural haematoma
  1. Joana Tavares1,
  2. Inês Freire2,
  3. Cristina Branco2 and
  4. Ana Luís1
  1. 1Neurosurgery Department, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
  2. 2Neurorradiology Department, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
  1. Correspondence to Dr Joana Tavares; joanamst{at}hotmail.com

Abstract

Spontaneous spine epidural haematoma is a rare occurrence, with an incidence of 0.1/100 000 inhabitants/year. The anterior location of the haematoma is very uncommon since the dural sac is firmly attached to the posterior longitudinal ligament. Vertebral artery dissection as its underlying cause is an exceptionally rare event, with only two documented cases.

This article presents the case of young woman who arrived at the emergency room with a spinal ventral epidural haematoma extending from C2 to T10, caused by a non-traumatic dissecting aneurysm of the right vertebral artery at V2–V3 segment. Since the patient was tetraparetic, she underwent emergent laminectomy, and the vertebral artery dissection was subsequently treated endovascularly with stenting.

Vertebral artery dissection with subsequent perivascular haemorrhage is a possible cause of spontaneous spine epidural haematoma, particularly when located ventrally in the cervical and/or high thoracic column. Hence the importance of a thorough investigation of the vertebral artery integrity.

  • Neuroimaging
  • Neurological injury
  • Spinal cord
  • Interventional radiology

https://doi.org/10.1136/bcr-2023-259591

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: JT and IF. The following authors gave final approval of the manuscript: JT, AL, IF, CB.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer-reviewed.