A Traumatic Cervical Epidural Hematoma that Showed Rapid Progression and Significant Improvement Without Surgery

Case: A 76-year-old woman receiving ongoing aspirin
therapy was transported by ambulance following
a traffic accident. Before her arrival, about 30
min after the accident, she began complaining of
dyspnea and developed quadriparesis. On admission,
we performed tracheal intubation and initiated artificial
ventilation. Computed tomography of the neck
revealed cervical epidural hematoma anterior to the
cervical spinal cord, from the first to sixth cervical
vertebrae. Within four hours of the traffic accident,
she demonstrated gradual improvement in movement
in her upper extremities.
Outcome: The patient was discharged home without
significant complications on Day 19.
Conclusion: We suggest the consideration of nonsurgical
management of traumatic cervical epidural
hematoma when the patient’s condition is rapidly
improving, with onsite facilities for neurosurgery in
reserve if surgical management becomes necessary.