Spontaneous spinal epidural hematoma is a rare but significant condition of spinal cord compression. Urgent decompressive surgery is generally indicated to prevent serious permanent neurological deficits and improve outcome. We encountered a case of an 83-yearold woman who sustained sudden onset of severe back pain, followed by progressive weakness and numbness over bilateral lower limbs. Magnetic resonance imaging of thoracic and lumbar spine demonstrated an epidural mass extending from T9 through L4, causing spinal cord and thecal sac compression. Emergent decompressive surgery was performed, and epidural hematoma was diagnosed postoperatively; the patient had significant improvement of neurologic deficits. The relevant literature is also reviewed.
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