Spontaneous spinal epidural hematoma is an uncommon but devastating problem. Rapid diagnosis and immediate intervention are essential because any delay in diagnosis could increase mortality and morbidity.

  Our case was a 56 years old man presented by pain in interscapular area and neck that rapidly progressed to lower extremity weakness and urinary retention. The patient had history of prosthetic heart valve replacement and warfarin consumption. MRI of thoracic region revealed epidural mass in posterior surface of thoracic cord between T1 to T7 levels. Laboratory findings disclosed INR (International normalized Ratio) of 5. Thoracic decompressive laminectomy was performed and epidural hematoma evacuated and no other pathology was found. 4 months after surgery patient was able to walk with cane. Spontaneous spinal epidural hematoma is a rare disease among most other conditions causing cord compression. It needs rapid diagnosis and surgical intervention to lessen complications. Neurologic outcome of patients depends on severity of neurologic deficit, time interval between onset of symptoms and surgery, size of hematoma and spinal cord edema.  

  Source: Urmia Med J 2011: 22(1): 75 ISSN: 1027-3727