Investigation and Treatment
On admission to the emergency hospital, her blood pressure was
152/82mmHg and pulse was 60/min. She had mild delirium. Routine blood
analysis showed renal function tests were raised (blood urea nitrogen
28.0mg/dl and serum creatinine 2.11mg/dl). Serum electrolytes ware
normal.
Brain MR imaging showed left occipital white matter and left cerebellum
slight hyperintensities on fluid-attenuated inversion recovery
(FLAIR)-sequences (Fig.1 a). MR imaging of the spine showed a large
epidural hematoma compressing the dorsolateral surface of spinal cord at
the levels C2-Th4 (Fig.1 c-d) and intramedullary hematoma at C4/5 (Fig.1
e). No abnormally enlarged vessels were observed on T2 weighted image.
Next day, on admission to our hospital, she was still confused, and her
clinical findings were not improved. Brain and spinal MR performed,
spinal epidural hematoma was not decreased and white matter of right
temporooccipital lobes and cerebellum FLAIR high lesions were revealed
clearly (Fig.1 b). She underwent a C3-T1 hemi-laminectomy and removal of
epidural hematoma.