Abstract
Background
Spinal epidural hematoma (SEH) after acupuncture is rare and may present with acute
or subacute onset and varied symptoms, making it difficult to diagnose. This condition
can mimic acute stroke, so it is vital to establish a clear diagnosis before considering
thrombolytic therapy, which could be disastrous if applied inappropriately.
Case Report
We describe a 52-year-old man who presented to our emergency department (ED) with
acute onset of unilateral weakness of the limbs for 3.5 h immediately after receiving
acupuncture at the bilateral neck and back. The acute stroke team was activated. In
the ED, computer tomography angiography from the aortic arch to the head revealed
spinal epidural hematoma. The patient was admitted to the ward for conservative treatment
and was discharged with subtle residual symptoms of arm soreness 5 days later.
Why Should an Emergency Physician Be Aware of This?
Acute spinal epidural hematoma rarely presents with unilateral weakness of the limbs,
mimicking a stroke. Because inappropriate thrombolysis can lead to devastating symptoms,
spinal epidural hematoma should be excluded when evaluating an acute stroke patient
with a history of acupuncture who is a possible candidate for thrombolytic therapy.
Keywords
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Article info
Publication history
Published online: March 20, 2020
Accepted:
January 12,
2020
Received in revised form:
November 27,
2019
Received:
August 1,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
