{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T04:21:34Z","timestamp":1763698894268,"version":"3.45.0"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Spontaneous hematomyelia, or non\u2010traumatic intramedullary spinal cord hemorrhage, is a rare and potentially devastating neurological condition. Unlike hematomyelia resulting from overt trauma, spontaneous cases occur in the absence of significant injury and present substantial diagnostic and therapeutic challenges. Etiologies are diverse and include spinal cord neoplasms, coagulopathies, anticoagulant use, spinal arteriovenous malformations (AVMs), radiation\u2010induced vasculopathy, minor mechanical insults, and systemic inflammatory conditions such as COVID\u201019. Given its rarity and the high risk of permanent neurological impairment, timely recognition is essential. We report the case of a previously healthy 19\u2010year\u2010old male who developed sudden\u2010onset lower limb weakness and back pain following a session of push\u2010up exercises. Within 3\u2009h, he progressed to complete paraplegia. Initial treatment at a local primary hospital was unsuccessful, and he was referred to Hawassa University Comprehensive Specialized Hospital on the fourth day of illness. Magnetic resonance imaging (MRI) of the spine revealed an intramedullary spinal cord hemorrhage consistent with spontaneous hematomyelia. Based on imaging features and clinical context, a presumptive diagnosis of juvenile spinal AVM was made; however, digital subtraction angiography (DSA) was not feasible due to financial and infrastructural constraints. The patient received conservative management, including supportive care and physiotherapy. Unfortunately, no neurological recovery was observed at nine\u2010month follow\u2010up. This case underscores the need to consider spontaneous hematomyelia in the differential diagnosis of acute flaccid paraplegia, especially in young, previously healthy individuals without trauma or anticoagulant exposure. It also raises awareness of physical exertion, such as upper\u2010body resistance exercise, as a potential trigger for spinal AVM rupture. Moreover, the case highlights the significant impact of limited diagnostic and therapeutic resources in low\u2010income settings, which may hinder timely intervention and worsen neurological outcomes.<\/jats:p>","DOI":"10.1002\/ccr3.70633","type":"journal-article","created":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T04:53:46Z","timestamp":1752296026000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Catastrophic Neurological Collapse Following Push\u2010Up Exercise: A Rare Case of Spontaneous Hematomyelia Causing Acute Paraplegia in a Healthy Young Adult"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9433-9652","authenticated-orcid":false,"given":"Yegzeru","family":"Belete","sequence":"first","affiliation":[{"name":"School of Medicine, College of Medicine and Health Sciences Hawassa University  Hawassa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abera","family":"Kuma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Neurology Unit, College of Medicine and Health Sciences Hawassa University  Hawassa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7040-9858","authenticated-orcid":false,"given":"Amanuel","family":"Anegagregn","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine and Health Sciences Hawassa University  Hawassa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulkerim","family":"Girma","sequence":"additional","affiliation":[{"name":"Department of Radiology NewYork Internal Medicine Specilaity Clinic  Hawassa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701\u2010004\u20100458\u20102"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2004.02.021"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101704"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100054154"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102516.2006.01276.x"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/sneu.2003.50017"},{"issue":"3","key":"e_1_2_14_8_1","first-page":"402","article-title":"Detection of Spinal Dural Arteriovenous Fistulae With MR Imaging and Contrast\u2010Enhanced MR Angiography: Sensitivity, Specificity, and Prediction of Vertebral Level","volume":"23","author":"Saraf\u2010Lavi E.","year":"2002","journal-title":"American Journal of Neuroradiology"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.2.FOCUS0953"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31815a5a0a"},{"issue":"5","key":"e_1_2_14_11_1","first-page":"1051","article-title":"Peripheral Spinal Cord Hypointensity on T2\u2010Weighted MR Images: A Reliable Imaging Sign of Spinal Vascular Malformations","volume":"16","author":"Hurst R. 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