Spontaneous spinal epidural hematoma in a young individual associated with hypertension

Abstract

Spontaneous spinal epidural hematoma (SSEH) is a rare cause of acute spinal cord compression. The exact etiology of this entity is not known, and it has been associated with blood dyscrasias, coagulopathy, infection, tumor, vascular malformations, and hypertension in the literature. Emergency surgical decompression is the treatment of choice, however, lately conservative management of SSEH has been advocated in the literature for a particular group of patients whose clinical profile shows early improvement of their neurological status. We report a case of SSEH in a 24-year-old male who had severe hypertension at the onset of the SSEH leading to quadriparesis, and he was managed conservatively. The patient’s blood pressure (BP) normalized over the next few weeks as the patient recovered neurologically. This direct association of hypertension with SSEH has been reported only in a few case reports. The normalization of BP in this case is unexplainable.

Keywords

• conservative
• cord compression
• epidural
• hematoma
• hypertension
• spontaneous