Chronic lumbar epidural haematoma presenting with acute paraparesis

Chronic spinal epidural haematomas are very rare and have been reported to occur only in the lumbar region. They usually become symptomatic through radicular pain or neurogenic claudication. The epidural bleeding is thought to originate from a rupture of an epidural vein due to a sudden increase in intra-abdominal pressure or due to trauma. The patient reported on here developed acute paraparesis about 8 weeks after a mild fall on the buttocks. MRI showed a spinal epidural mass located dorsolaterally at the level of L3-L5. The mass was surgically removed. Histological and immunohistological studies disclosed an organised haematoma. The clinical, radiological and intra-operative features of this case are described, and the relevant literature is analysed.