Spinal cord hemorrhage in a patient with neurosarcoidosis on long-term corticosteroid therapy: case report

Benoit Pegat (1) , Sophie Drapier (1) , Xavier Morandi (2) , Gilles Edan (1)

1 Département de Neurologie [CHU Rennes]
2 Service de neurochirurgie [Rennes] = Neurosurgery [Rennes]

BACKGROUND: Central nervous system bleeding is a rare complication of neurosarcoidosis: only 18 cases of spontaneous cerebral hematoma have been reported. We present the first recorded case of spinal cord hemorrhage in neurosarcoidosis.CASE PRESENTATION: A 48-year-old Caucasian woman had relapsing neurosarcoidosis for 5 years, with inflammatory spinal and cerebral lesions. While on 20 mg corticosteroids, she experienced subacute paraparesia with right leg pain. A spine MRI revealed a low thoracic hematomyelia at the T10-T11 level. Despite high doses of corticosteroids, her condition continued to worsen. Surgical evacuation of the hematoma was performed 10 days after the onset of bleeding, and she partially recovered.CONCLUSION: This report highlights the possibility of spinal cord hemorrhage secondary to sarcoid vasculitis. The patient improved after surgical evacuation of the intramedullary hematoma. Immuno-modulating agents must be envisaged in severe neurosarcoidosis, to prevent complications

Domains: Life Sciences [q-bio]

Benoit Pegat, Sophie Drapier, Xavier Morandi, Gilles Edan. Spinal cord hemorrhage in a patient with neurosarcoidosis on long-term corticosteroid therapy: case report. BMC Neurology, 2015, 15 (1), pp.123. ⟨10.1186/s12883-015-0373-6⟩. ⟨hal-01187426⟩