Traumatic C1-C3 Spinal Epidural Hematoma Presented with Occipital Neuralgia

Abstract

A 32-year-old woman presented to our hospital with occipital headache for >1 week following head trauma. She showed no other neurologic symptoms. Pain was aggravated by cervical flexion. Magnetic resonance imaging (MRI) findings showed a spinal epidural hematoma (SEH) at the C1 to C3 level. The C2 roots were encircled and compressed by the hematoma. Medication was prescribed and a neck collar was applied for symptom control. After three weeks, her occipital neuralgia disappeared and cervical flexion did not provoke pain. Follow-up MRI findings showed total resolution of the SEH. The findings of this case illustrate that occipital neuralgia, especially if characterized by rapid onset, can be caused by SEH after trauma.