Idiopathic Thoracic Spontaneous Spinal Epidural Hematoma

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• A 33-year-old male presented with progressive lower extremity weakness and sensory loss.
• Initial diagnosis considered transverse myelitis and Guillain-Barre syndrome (GBS).

Purpose of the Study:

• To report a case of spinal cord compression mimicking myelitis and GBS.
• To highlight the diagnostic utility of MRI in identifying spinal masses.

Main Methods:

• Clinical neurological examination.
• Thoracic magnetic resonance imaging (MRI).

Main Results:

• Neurological exam revealed paraplegia, bilateral Babinski signs, and sensory deficits below T10.
• MRI demonstrated a mass compressing the thoracic medulla, causing the patient's symptoms.
• The patient experienced urinary incontinence.

Conclusions:

• Spinal cord compression should be considered in the differential diagnosis of acute myelopathy.
• MRI is crucial for identifying the underlying cause of neurological deficits, distinguishing masses from inflammatory conditions like GBS.