Spontaneous epidural haematoma with spinal cord compression in pregnancy – A case report

Spontaneous epidural haematomas are rare, and few cases have been reported in pregnancy. Frequently with back pain, and rapidly progressing neurological changes where spinal cord compression is present, magnetic resonance imaging (MRI) is the gold standard for diagnosis. Management generally involve...

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Main Authors: Gabrielle Sach, Catherine Crouch, Sean Seeho
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:Case Reports in Women's Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S221491122500061X
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author Gabrielle Sach
Catherine Crouch
Sean Seeho
author_facet Gabrielle Sach
Catherine Crouch
Sean Seeho
author_sort Gabrielle Sach
collection DOAJ
description Spontaneous epidural haematomas are rare, and few cases have been reported in pregnancy. Frequently with back pain, and rapidly progressing neurological changes where spinal cord compression is present, magnetic resonance imaging (MRI) is the gold standard for diagnosis. Management generally involves prompt surgical decompression of the spinal cord. Limited access to specialist care and imaging in rural areas is a barrier to timely diagnosis and treatment.This case report outlines the diagnosis and management of a woman in her mid-twenties, presenting at 38 weeks of gestation to a rural hospital with back pain and lower limb weakness. MRI revealed spinal cord compression from an epidural cystic mass, suspected to be a haematoma. She was airlifted to a tertiary centre for an emergency caesarean section and subsequent laminectomy. Histopathology suggested an underlying arteriovenous malformation as the most likely cause. This case highlights the diagnostic and management challenges of spontaneous epidural hematomas in pregnancy, particularly in resource-limited rural environments.
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spelling doaj-art-e0793025c98b4f10ad593ced86ac0f5c2025-08-20T04:02:31ZengElsevierCase Reports in Women's Health2214-91122025-10-0147e0074010.1016/j.crwh.2025.e00740Spontaneous epidural haematoma with spinal cord compression in pregnancy – A case reportGabrielle Sach0Catherine Crouch1Sean Seeho2Department of Obstetrics & Gynaecology, Royal North Shore Hospital, Northern Sydney Local Health District, Reserve Rd, St Leonards, NSW 2065, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Technology Place, Macquarie Park, NSW 2113, Australia; Corresponding author at: Department of Obstetrics & Gynaecology, Royal North Shore Hospital, Northern Sydney Local Health District, Reserve Rd, St Leonards, NSW 2065, Australia.Department of Obstetrics & Gynaecology, Royal North Shore Hospital, Northern Sydney Local Health District, Reserve Rd, St Leonards, NSW 2065, Australia; Northern Sydney (Arabanoo) Precinct, Faculty of Medicine and Health, The University of Sydney, Science Rd, Camperdown, NSW 2050, AustraliaDepartment of Obstetrics & Gynaecology, Royal North Shore Hospital, Northern Sydney Local Health District, Reserve Rd, St Leonards, NSW 2065, Australia; Northern Sydney (Arabanoo) Precinct, Faculty of Medicine and Health, The University of Sydney, Science Rd, Camperdown, NSW 2050, Australia; Women and Babies Research, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Westbourne St, St Leonards, NSW 2064, Australia; Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Science Rd, Camperdown, NSW 2050, AustraliaSpontaneous epidural haematomas are rare, and few cases have been reported in pregnancy. Frequently with back pain, and rapidly progressing neurological changes where spinal cord compression is present, magnetic resonance imaging (MRI) is the gold standard for diagnosis. Management generally involves prompt surgical decompression of the spinal cord. Limited access to specialist care and imaging in rural areas is a barrier to timely diagnosis and treatment.This case report outlines the diagnosis and management of a woman in her mid-twenties, presenting at 38 weeks of gestation to a rural hospital with back pain and lower limb weakness. MRI revealed spinal cord compression from an epidural cystic mass, suspected to be a haematoma. She was airlifted to a tertiary centre for an emergency caesarean section and subsequent laminectomy. Histopathology suggested an underlying arteriovenous malformation as the most likely cause. This case highlights the diagnostic and management challenges of spontaneous epidural hematomas in pregnancy, particularly in resource-limited rural environments.http://www.sciencedirect.com/science/article/pii/S221491122500061XObstetrics and gynaecologyCaesarean sectionSpontaneous epidural haematoma
spellingShingle Gabrielle Sach
Catherine Crouch
Sean Seeho
Spontaneous epidural haematoma with spinal cord compression in pregnancy – A case report
Case Reports in Women's Health
Obstetrics and gynaecology
Caesarean section
Spontaneous epidural haematoma
title Spontaneous epidural haematoma with spinal cord compression in pregnancy – A case report
title_full Spontaneous epidural haematoma with spinal cord compression in pregnancy – A case report
title_fullStr Spontaneous epidural haematoma with spinal cord compression in pregnancy – A case report
title_full_unstemmed Spontaneous epidural haematoma with spinal cord compression in pregnancy – A case report
title_short Spontaneous epidural haematoma with spinal cord compression in pregnancy – A case report
title_sort spontaneous epidural haematoma with spinal cord compression in pregnancy a case report
topic Obstetrics and gynaecology
Caesarean section
Spontaneous epidural haematoma
url http://www.sciencedirect.com/science/article/pii/S221491122500061X
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AT catherinecrouch spontaneousepiduralhaematomawithspinalcordcompressioninpregnancyacasereport
AT seanseeho spontaneousepiduralhaematomawithspinalcordcompressioninpregnancyacasereport