Paraparesis following straining accompanied by spontaneous thoracolumbar spinal epidural hematoma: a case report

Spontaneous spinal epidural hematoma (SSEH) is a rare disease that requires emergency surgical intervention because it can cause serious and permanent neurological damage. Its etiology is related to coagulopathy, vascular malformation, hypertension, neoplasms, infections and idiopathic causes. It is frequently observed in the cervicothoracic and thoracolumbar regions. Inadequate spinal vascularization of the thoracolumbar junction increases the risk of spinal infarcts in lesions in this region. Therefore, prompt and effective surgical intervention is critical in patients with a thoracolumbar SSEH. We conclude that prognosis would be better than it is if patients with complete neurological damage were to undergo spinal decompression within the first 36 hours, and patients with incomplete neurological damage were operated on in the first 48 hours. We report a 71-year-old female patient with a history of aspirin use who developed paraparesis accompanied by SSEH following straining, and emphasize the importance of early surgical treatment.