Non-traumatic Hematomyelia: A Rare Finding in Clinical Practice

Eur J Case Rep Intern Med. 2018 Nov 28;5(11):000961. doi: 10.12890/2018_000961. eCollection 2018.

Abstract

Non-traumatic haematomyelia is a rare finding of acute onset, which in most cases is the result of arteriovenous malformations (AVM), tumours, coagulation disorders or autoimmune conditions, but may also be secondary to treatment with anticoagulants and radiotherapy. We present the case of a 58-year-old woman with sudden onset cervical pain, followed by asymmetric diminution of strength in the upper limbs with reduced pain sensitivity. The diagnosis of AVM at the C7 and D1 levels was made following cervico-dorsal magnetic resonance imaging and angiography. Treatment was embolization with immediate isolation of the AVM.

Learning points: Central nervous system lesions (including subarachnoid haemorrhage) can be located in the spine as well as the brain.Subarachnoid haemorrhage can be diagnosed through examination of the cerebrospinal fluid, especially when the CT scan is normal in patients with typical signs of this condition (acute neurological deficits with pain and signs of meningeal irritation like fever or neck rigidity).Non-traumatic haematomyelia is a rare finding.

Keywords: Haematomyelia; angiography; arteriovenous malformations; magnetic resonance imaging; spinal cord.