• A Oliviero, A Insola, V Santilli, T Tartaglione, P Profice, P Tonali, and V Di Lazzaro.
• Istituto di Neurologia, Università Cattolica, Rome, Italy. Famiglia,
• Spine. 2000 Apr 1; 25 (7): 888-90.

Study DesignA case report.ObjectivesTo report and discuss a case of post-traumatic epidural hematoma of the craniocervical junction with concomitant brain stem infarction.Summary Of Background DataPost-traumatic epidural hematoma of the cervical spine and brain stem post-traumatic infarction are very rare disorders. Post-traumatic epidural hematoma is usually located dorsally in the epidural space.MethodsThe clinical, neuroradiologic, and neurophysiologic findings in one patient with post-traumatic epidural hematoma located ventrally at the cervicomedullary junction and associated with medial infarction at the pontomedullary junction are reported.ResultsThe main clinical finding in this patient was bilateral corticospinal and corticobulbar tract involvement. A magnetic resonance image showed displacement and flattening of the medulla oblongata and of the most cranial portion of cervical cord, which were caused by the epidural hematoma associated with an ischemic lesion of the pontomedullary junction. Results of central motor conduction studies indicated that the abnormality of the central motor pathways was localized at brain stem level, and that there was normal conduction from the cervicomedullary junction to spinal cord.ConclusionThis is the first reported case of spinal epidural hematoma located ventrally in the cervical spine at the cervicomedullary junction level and concomitant infarction at the pontomedullary junction resulting from whiplash injury.

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