The patient came to the clinic 03-October-2010 complaining of agonizing neck and right upper limb pain with numbness of the right hand for 2 weeks.

MRI cervical spine performed 03-October-2010 showing extruded disc C6-7 with complete occlusion of the right foramen.

On examination: The patient was all the time holding her right upper limb above the head. She was deprived of sleeping for several days. There was horizontal nystagmus when looking to both directions. Romberg was stable. The biceps of the right upper limb was weak -4/5, grip right hand 3/5, extension of the hand 2/5 and the triceps was 2/5 also. She had hypalgesia of the right side of the face and the entire right upper limb. Movement of the neck to all direction was painful and with limitation. There is weak quadriceps right lower limb +3/5. It was explained to the patient that the hypalgesia of the right side of the face cannot be explained by the extruded disc, but she insisted that she had hypalgesia.

CT-scan of the brain was requested and done 04-October-2010 and it was normal.

Discectomy of the C6-7 was performed. The extruded disc was removed in one piece, after what massive arterialized venous bleeding took place for 40 sec, which stopped by itself. Further inspection for the extrusion. 

Routine closure of the wound and smooth postoperative recovery and the power of the right upper limb dramatically improved.

The patient was in agonizing pain and several nights without sleep. She exaggerated her clinical picture, that it was necessary to perform brain CT-scan to rule out other lesions.

The bleeding was mostly due to compressed epidural vein. In case that the vertebral artery is the source of bleeding, the bleeding will take a lot of time and it will need further measures to control it.