Acute spinal epidural hematoma: A case report and review of the literature

Abstract

Spinal epidural hematoma (SEH) is a rare but a significant cause of spinal cord compression and neurologic deficits. Its etiology is usually unknown and requires emergency intervention. The present study aims to review the clinical significance, treatment strategies and clinical outcomes of traumatic SEH with a rare case presentation. Our patient was a 42-year-old female who presented with back pain and loss of sensation and strength in the legs. The patient did not have any disease and did not use anticoagulant drugs. The patient developed numbness in her legs half an hour after having a traditional back walking massage due to occasional back pain. She was paraplegic and anesthetic when seen in our clinic. Thoracic computed tomography (CT) and magnetic resonance imaging (MRI) revealed posterior epidural hemorrhage at Th3-Th4 levels. In the 12th hour, the hematoma was evacuated by an emergency decompressive hemilaminectomy. At the postoperative 24th hour, the patient had symptomatic improvement, and in the sixth month, the patient was mobilized with support. SEH is a rare condition that should be considered in patients with sudden onset of back pain and extremity weakness. Although the gold standard diagnostic tool is MRI, CT is often sufficient to avoid delayed surgery. Immediate surgical decompression (laminectomy/hemilaminectomy) should be performed in cases diagnosed with SEH with neurological deficits.