Patient T.N. M. Q. (male, born in 1991, Ho Chi Minh City) suddenly became weak in limbs, collapsed and was taken to the emergency room. The patient was admitted at Military Hospital 175 in a state of quadriplegia, the right side being more severe than the left; awake, able to access but not urinating on his own.
At the Emergency Department, due to the manifestation of acute paralysis, the patient was initially diagnosed with brain stroke monitoring. However, through clinical examination combined with brain and cervical resonance imaging, doctors recorded an extradural hematoma of the cervical spinal cord in the C3-C5 region causing cervical spinal cord compression. The patient was then urgently transferred to the Spinal Department for specialized treatment.
At the Spinal Department, Institute of Traumatology and Orthopedics, Military Hospital 175, through in-depth evaluation, doctors determined that the cause of paralysis was a spinal cord compression.
This is a rare condition, progressing rapidly and potentially leaving severe neurological sequelae if not treated promptly. Faced with severe developments, the team decided to perform emergency surgery immediately that night to remove blood clots and relieve spinal cord compression.
After surgery, the patient was monitored at the Intensive Care Unit, Military Hospital 175 for the first 24 hours due to spinal cord edema. When the condition stabilized, the patient was intubated and transferred to the Spinal Column Department for further treatment. Postoperative developments showed clear improvement in motor function, with lower extremity muscle strength increasing to 3/5 right from the 2nd day. By the 7th day, the left side was almost completely recovered, while the right side also improved significantly and reached 3/5.
Dr. Huynh Thanh Binh, Head of the Department of Spine - Institute of Trauma and Orthopedics, Military Hospital 175, said that spontaneous epidural hematoma of the cervical spinal cord is a condition of sudden bleeding causing acute spinal cord compression. If not diagnosed and treated promptly, the initial injury can progress to secondary lesions such as spinal edema, spinal softening. The optimal treatment principle is early dissection surgery to remove blood clots, help the spinal cord to be released and create conditions for nerve function recovery.
According to Dr. Huynh Thanh Binh, the time of intervention is decisive for the treatment outcome. If surgery is performed early, most cases can recover almost completely. The "golden" time in treating epidural hematoma is from 6 to 12 hours from the onset. In cases of obvious spinal cord compression, early intervention is needed, because after this time, treatment will become more difficult and the risk of sequelae increases.
After surgery, the patient continued to receive medical treatment combined with functional rehabilitation.
