Recurrent spontaneous spinal epidural hematoma leading to compressive myelopathy

Abstract

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.