[A 90-year-old woman with acute hemiparesis].

Abstract

A right-handed woman of 90, taking aspirin 160 mg daily, suffered acute neck pain radiating to the shoulders, with right side hemiparesis and numbness occurring minutes thereafter. On admission 2.5 hrs later, examination showed paresis and hyporeflexia of the right limbs accompanied by neck stiffness and vertebral tenderness in level C7. Acute stroke was the initial working diagnosis. Cerebral CT was normal. Symptoms progressed with left arm numbness and left ancle clonus, and eight hours after symptom onset there was bilateral plantar inversion, reduced skin prick sensibility below C4, bladder paresis and anal sphincter hypotonia. CT myelography revealed an intraspinal mass extending from C2 to C6. 14 hours after symptom onset, a spinal epidural haematoma was removed by spinal laminectomy. Recovery and functional outcome was good. Symptoms, work-up and treatment are discussed with reference to previous publications.

• Authors: Petter Schandl Sanaker, Mads Aarhus, Morten Lund-Johansen, Alf Inge Smievoll, Charalampos Tzoulis, Geir Olve Skeie
• Journal: Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke (Tidsskr Nor Laegeforen) Vol. 126 Issue 15 Pg. 1931-3 (Aug 10 2006) ISSN: 0807-7096 [Electronic] Norway
• Vernacular Title: En 90 år gammel kvinne med akutt hemiparese.
• PMID: 16937574 (Publication Type: Case Reports, Journal Article)

Topics

• Acute Disease
• Aged, 80 and over
• Diagnosis, Differential
• Female
• Hematoma, Epidural, Spinal (complications, diagnostic imaging, surgery)
• Humans
• Myelography
• Paresis (diagnosis, etiology, rehabilitation)
• Recovery of Function