Rapid Spontaneous Resolution of Idiopathic Cervico-thoracic Ventral Epidural Hematoma

Abstract

Spontaneous spinal epidural hematoma (SSEH) has been rarely reported in the literature. Prompt surgical intervention is recommended for patients with neurologic deficit. However. in rare cases, spontaneous resolution of the SSEH with recovery of the neurological deficit has also been reported. We report a case of SSEH in a 55-year-old woman with a rapidly progressing neurological deficit. Her neurological deficits gradually improved sponta- neously during preoperative evaluation. Serial magnetic resonance imaging(MRI) demonstrated disappearance of the hematoma. Since her neurological status improved within a few hours, we recommended conservative care. Patients initially presenting with severe neurologic dysfunction are potential candidates for conservative management if they demonstrate rapid and progressive improvement in neurologic function. Thus, immediate surgical decompression may not be necessary if neuroimaging and clinical examinations suggest that spinal epidural hematoma will spontaneously resolve.