@article{ref1,
title="Massage-induced spinal epidural hematoma presenting with delayed paraplegia",
journal="American journal of emergency medicine",
year="2019",
author="Vanichkulbodee, Alissara and Issaragrisil, Suwara and Inboriboon, Pholaphat Charles",
volume="37",
number="4",
pages="797.e1-797.e4",
abstract="BACKGROUND: Spinal epidural hematoma (SEH) is an uncommon but serious emergency condition rare cases of spontaneously or following a minor traumatic event without bony injury. <br><br>OBJECTIVE: We report the rare case of SEH associated with traditional massage initially presenting with delayed lower paraplegia. CASE REPORT: A 20-year-old man presented with bilateral lower extremity weakness and numbness 3 h prior to presentation. 3 days prior he was given a layperson Thai massage by a friend. Magnetic resonance imaging revealed a spinal epidural lesion suspicious for hematoma extending from C6 to T2 levels. Emergent surgical intervention for cord decompression was performed. An epidural hematoma with cord compression at C6-T2 levels was identified intraoperatively. No evidence of abnormal vascular flow or AV malformations was identified. Similar to chiropractic manipulation, massage may be associated with spinal trauma. <br><br>CONCLUSION: Emergency physicians must maintain a high index of suspicion for spinal epidural hematomas in patients with a history of massage or chiropractic manipulation with neurologic complaints, because delays in diagnosis may worsen clinical outcome.<br><br>Copyright © 2019 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0735-6757",
doi="10.1016/j.ajem.2019.01.017",
url="http://dx.doi.org/10.1016/j.ajem.2019.01.017"
}