Spontaneous spinal epidural hematoma during pregnancy: case report and literature review

Spinal epidural hematoma is a rare cause of spinal cord compression and acute para- or quadriplegia. Traumatic spinal epidural hematomas are usually seen in older men with a history of ankylosing spondylitis and vertebral fracture. Spontaneous spinal epidural hematomas are commonly associated with coagulopathies, tumors, or vascular malformations. There have been only five previously published case reports in the English-language literature of spontaneous spinal epidural hematomas in conjunction with pregnancy.

We present the case of a 24-year-old woman at 20 weeks' gestation who presented to our service with a spontaneous cervicothoracic spinal epidural hematoma and complete quadriplegia.

The patient was taken to the operating room for urgent surgical decompression and evacuation of the spinal epidural hematoma.

The patient made a complete neurological recovery in long-term follow-up. In the meantime, she carried her pregnancy to term and gave birth to a healthy baby. Therefore, we advocate aggressive and early surgical intervention, similar to the five previously reported cases in the English-language literature, in the case of a spinal epidural hematoma causing cord compression and devastating neurological deficit in a pregnant woman.