The blood tests showed an INR of 1.09 (normal laboratory value 0.90-1.22) and a hemoglobin of 11.2 gr / dl (12gr / dl-16 gr / dl) with the rest of the laboratory parameters normals. A chest x-ray was performed that no reveal significant findings (Figure 2).

Inmmediately, a cervical CT scan was made that showed a parenchymal laceration of the right thyroid lobe with hematoma evolved in the ipsilateral laterocervical region and in the superior mediastinum without evidence of compatible images with aneurysms in the arterial territories studied (Figure 3).
  
As the patient was stable at the moment of diagnosis it was decided to admit to the hospital for monitoring and watching. The following day, a control blood tests were made, in where the decrease of one hemoglobin point was observed (10.3 gr / dl), so transfusion of blood was not necessary. The patient was in digestive rest, with fluid therapy for the first 3 days. From the fourth day and given the respiratory and hemodynamic stability, it was decided to start the oral intake with good tolerance. During her stay in the hospital, the patient remained hemodynamically stable without respiratory symptoms, being discharged after 72 hours of hospitalization.
  




Figure  1 Spontaneous cervical hematoma in elderly women.

 









Figure  2 Normal chest X-Ray.



 









Figure  3 CT scan that shows cervical hematoma and thyroid  disruption.