Recurrent spontaneous spinal epidural hematoma leading to compressive myelopathy

Published:January 09, 2014DOI:
      Spontaneous spinal epidural hematoma accounts for most cases of spinal epidural hematoma, but very few cases of recurrent spontaneous spinal epidural hematoma have been published to date. We herein report a case of a 20-year-old man who presented with 10-day history of pain in the interscapular region, followed by paraparesis and sensory loss below umbilicus along with urinary retention. The patient gave history of 2 similar episodes in the last 3 months, with complete spontaneous recovery. His magnetic resonance imaging of dorsal spine was suggestive of subacute spinal epidural hematoma. On reviewing previous 2 magnetic resonance images of dorsal spine, it was apparent that the patient had recurrent hematoma at the same site. Thus, a provisional diagnosis of recurrent spontaneous spinal hematoma at the level of upper dorsal spine was kept and was managed accordingly. Patient with recurrent spontaneous spinal epidural hematoma should be educated about the nature of the disease and advised to consult a neurosurgeon as early as possible in case of a relapse, so that they can undergo surgical management preferably within 8 hours and not later than 36 hours.
      To read this article in full you will need to make a payment
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Rath S.A.
        Spinal hematoma: a literature survey with meta-analysis of 613 patients.
        Neurosurg Rev. 2003; 26: 50
        • Foo D.
        • Rosier A.B.
        Preoperative neurological status in predicting surgical outcome of spinal epidural hematomas.
        Surg Neurol. 1981; 15: 389-401
        • Abram H.S.
        • DeLaHunt M.J.
        • Merinbaum D.J.
        • Hammond D.N.
        Recurrent spontaneous spinal epidural hematoma in a child: first case report.
        Pediatr Neurol. 2007; 36: 177-180
        • Patel H.
        • Boaz J.C.
        • Phillips J.P.
        • Garg B.P.
        Spontaneous spinal epidural hematoma in children.
        Pediatr Neurol. 1998; 19: 302-307
        • Ravid S.
        • Schneider S.
        • Maytal J.
        Spontaneous spinal epidural hematoma: an uncommon presentation of a rare disease.
        Childs Nerv Syst. 2002; 18: 345-347
        • Beatty R.M.
        • Winston K.R.
        Spontaneous cervical epidural hematoma. A consideration of etiology.
        J Neurosurg. 1984; 61: 143-148
        • Groen R.J.
        • Ponssen H.
        The spontaneous spinal epidural hematoma. A study of the etiology.
        J Neurol Sci. 1990 Sep; 98: 121-138
        • Groen R.J.
        • van Alphen H.A.
        Operative treatment of spontaneous spinal epidural hematomas: a study of the factors determining postoperative outcome.
        Neurosurgery. 1996; 39: 494-508
        • Kreppel D.
        • Antoniadis G.
        • Seeling W.
        Spinal hematoma: a literature survey with meta-analysis of 613 patients.
        Neurosurg Rev. 2003; 26: 1-49