Cervical Epidural Hematoma and Cord Compression in a Hemophilia A Patient with Elevated Factor VIII Inhibitor Levels after Minor Trauma: A Case Report

Abstract

Study Design: Case report Objectives: To present a rare case of cervical epidural hematoma caused by mild cervical trauma in a Hemophilia A patient with factor VIII inhibitor. Summary of Literature Review: Spinal epidural hematoma is a rare but serious condition that can cause acute neurological deficits. Coagulopathies, including hemophilia, are uncommon but important etiologies. Materials and Methods: A 54-year-old male patient with hemophilia A and an elevated factor VIII inhibitor level presented with right upper and lower extremity motor weakness due to a cervical epidural hematoma superimposed on ossification of the posterior longitudinal ligament. Adequate decompression was achieved through cervical laminoplasty. After admission to the hematology department, meticulous perioperative management was implemented to minimize bleeding risk, enabling surgery to be performed safely. Results: The patient showed marked neurological recovery following surgery and was discharged without any notable postoperative complications. Conclusions: This case shows that not just rapid, but also safe surgery by a multidisciplinary approach is important in treating epidural hematomas in hemophilia patients. © 2025 Korean Society of Spine Surgery.