Competing interests The authors declare that they have no competing interests. Authors’ contributions ND and JB contributed equally to the work. ND participated in the design of the study, and acquisition of data. JB draft
the manuscript. BA participated in the acquisition of data. TD, KA, NM, and AZ participated in the Carfilzomib coordination of data. ABB participated in the coordination of the study. AAZ participated in the design of the study, and performed the statistical analysis. RA conceived of the study, participated in the design of the study, performed the statistical analysis and interpretation of data, and gave the final approval of Inhibitors,research,lifescience,medical the manuscript. All authors read and approved the final manuscript Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/11/12/prepub Inhibitors,research,lifescience,medical Acknowledgements We are greatly indebted to Dr Khoudri Ibtissam who assisted us to linguistic correction.
Spontaneous
Inhibitors,research,lifescience,medical spinal epidural hematoma (SSEH) is a rare cause of back pain in the emergency department (estimated incidence of approximately 0.1 per 100,000 patients per year [1]) but one that carries high morbidity. The classic clinical presentation is acute onset of severe, often radiating, back pain followed by signs and symptoms of nerve root and/or spinal cord compression, which develops minutes to days later [2-4]. The true etiology of SSEH remains unknown, but associations with some predisposing conditions, such as coagulopathies, blood dyscrasias and arteriovenous Inhibitors,research,lifescience,medical malformation, have been reported [5,6]. Although
there are occasional reports of nonoperative treatments, timely surgical extirpation of the epidural clot remains the standard management Inhibitors,research,lifescience,medical [7]. This article presents a previously healthy young man who was admitted to the emergency department with back pain and symptoms of spinal cord compression caused by SSEH, in whom prompt surgical treatment prevented definitive neurological sequelae. Case presentation A 34-year-old man presented to the emergency department with a 2-hour history of sudden acute severe back pain at the thoracic level. He described that the pain was initially dull and then became sharp. There was no history of trauma, drug use or any physical Dichloromethane dehalogenase exertion. The past medical history was unremarkable. On arrival, he was conscious and alert, with no respiratory distress and normal vital signs. The rest of the physical examination was normal. Initial laboratory tests including complete blood count, chemistry panel and coagulation evaluation revealed no remarkable contributions. During observation, at 3 hours from the beginning of the pain, the patient complained of weakness and numbness over the lower limbs.