Case Report Pediatr Neurosurg 2002;36:90–95 Cervical Hematomyelia: A Rare Entity in a Neonate with Cesarean Section and Surgical Recovery Çagatay Önal a Cengiz Yakinci b Ayhan Kocak a Rezzan Erguvan c Ayhan Tekiner a Ramazan Kutlu d Cemal Özcan e Abdulkadir Gul b Departments of a Neurosurgery, b Pediatrics, c Pathology, d Radiology and e Neurology, Inönü University School of Medicine, Malatya, Turkey Received: January 8, 2001 Accepted: November 8, 2001 Çagatay Önal, MD Cosnuk Mah., Necip Fazil Kisakurek Cad. 3. Sok. Safak-1 Apt, Daire:15 TR–44330 Malatya (Turkey) Tel. +90 532 442 06 00, E-Mail conal_tr@yahoo.com ABC Fax + 41 61 306 12 34 E-Mail karger@karger.ch www.karger.com © 2002 S. Karger AG, Basel 1016–2291/02/0362–0090$18.50/0 Accessible online at: www.karger.com/journals/pne Key Words Neonate W Hematomyelia W Spinal cord injury W Ultrasonography W Magnetic resonance imaging W Electrophysiology W Cesarean section Abstract Spinal cord injury with or without trauma has been reported in the perinatal period. The prognosis depends primarily on diagnosis of the level, extent and nature of the lesion, established by correlations between clinical, imaging and electrophysiological data. A 25-day-old boy with normal birth weight delivered at term by cesarean section was transferred to Inönü University Turgut Özal Medical Center because of respiratory distress and bra- chial diplegia. A suspicious medullary lesion on cervical computerized tomography was confirmed as an intrame- dullary lesion extending from C3 to D1 on magnetic reso- nance imaging (MRI). Emergent surgery consisting of exposure of the lesion site and interlaminar direct punc- ture of the lesion under fluoroscopy revealed that the pathology was an intramedullary hematoma. The partial evacuation of the lesion with direct puncture, the pa- tient’s neurological improvement and close follow-up of the patient with ultrasonography, electrophysiology and MRI are discussed in the light of recent literature. Copyright © 2002 S. Karger AG, Basel Introduction Hematomyelia is a rare entity which can be a result of various pathologies. Bleeding due to vascular malforma- tions, blood dyscrasia, syringomyelia, neoplastic growths and anticoagulant treatment are the most familiar reasons for the pathology [1–4]. Very rare cases such as infantile hematomyelia after vigorous resuscitation with apparent electrical cardioversion have been reported [5]. A more common form of spinal damage ranging from commotio to complete transsection during the neonatal period is seen due to birth trauma. Even though improvements in obstetrics have caused a significant decrease in the inci- dence of birth-related spinal injury during the last de- cades, one of the latest reported incidences is approxi- mately 1 in 29,000 live births [6]. This article reports a This paper was presented in part at the Fifth Regional Congress of Pediatric Societies of Turkish Speaking Countries, September 25–28, 1999, Bishkek, Kyrgyzstan. Ç.Ö. was a clinical observer in The Hospi- tal for Sick Children, Division of Neurosurgery, Toronto, Ont., Cana- da, supported by the Turkish Neurosurgical Society, from Novem- ber 2000 to November 2001.