Spontaneous spinal epidural hematoma

Spinal epidural hematoma is defined as spontaneous when there is no known underlying cause or predisposing bleeding factor. Its incidence is very low, approximately one per million inhabitants per year. However, it may cause acute and irreversible neurological symptoms. For this reason, it is considered a neurosurgical emergency that requires rapid diagnosis and treatment. The most common clinical presentation involves acute vertebral pain with radicular radiation to one or several limbs) followed by neurological signs below the lesion. Neuroradiology imaging, particularly the magnetic resonance imaging, will determine the topography and diagnosis. There are some case reports in the literature that resolved spontaneously, however, most patients require laminectomy and drainage of the hematoma. We report the case of a 65 year-old woman with a background of hypertension, who presented with an acute pain syndrome in the interscapular region radiating to both upper limbs, followed by right sided hemiparesis, as the initial symptom and sign of a spontaneous spinal epidural hematoma.