Spontaneous Spinal Epidural Hematoma

Abstract

Spontaneous spinal epidural hematoma (SSEH) is a rare condition with an incidence of 0.1 in 100,000 population. These are usually seen in the lumbar region in patients above 40 years and in the cervical and dorsal spine in younger patients. Posterior or dorsal epidural hematomas are more common than ventral hematomas. Patients present with sharp pain in the neck or back with or without neurological deficit. We present a case of a 20-year-old male who presented with quadriparesis and bowel and bladder incontinence for 5 days. No history of trauma or other aggravating factors were present. Magnetic resonance imaging revealed a posterior epidural hematoma with cord compression and edema. Patient underwent surgery and hematoma was evacuated. Patient symptoms improved gradually. Because of the severe preoperative neurological deficit and delay in surgery, patient had mild residual neurological deficit in the early post op period, which resolved over a period of two months