Spontaneous spinal epidural hematoma in a 4-month-old infant

Study design: A case report and a review of literature. Objectives: To present the first youngest infant of a 4-month-old boy with spontaneous spinal epidural hematoma in cervicothoracic spine. Setting: National Cheng Kung University Hospital, Tainan, Taiwan. Methods: A 4-month-old boy who initially presented with irritable crying, neck stiffness, and fever followed by progressive quadriparesis. Magnetic resonance imaging (MRI) of the spine disclosed a space-occupying lesion on the right posterior-lateral aspect of the cervicothoracic spinal canal. Laminectomy with reconstruction in situ from C4 to T4 was performed 5 days after the onset of symptoms. Results: The boy had gradual improvement of his neurological status. Follow-up visit 1 year later, the infant's growth and development was within normal limit without any neurological deficits; his repeat MRI showed complete fusion of each implanted lamina and well expansion of the spinal cord. Conclusions: Prompt surgical decompression is valuable, irrespective of the time interval between symptom onset and operation in infant.