Spinal Epidural Bleed in Hemophilia: A Rare Site of Bleeding With Complete Resolution With Nonsurgical Management

Hemophilia A is an inherited bleeding disorder, seen in 1 in 10,000 live births. It is characterized by an increased risk of bleeding, especially involving the musculoskeletal system. Central nervous system bleeding, including brain and spinal cord bleed is rare in the absence of overt trauma, seen in <5% patients. Epidural spinal bleeding in hemophilia is even rarer, and described in <20 patients so far in literature. We describe a young boy who presented with a cervical spine epidural bleed, and was managed conservatively without any sequelae. We also look at the controversies and recent evidence weighing surgical and conservative management of such bleeds.