A rare case of spontaneous spinal epidural hematoma in a 43-year-old man

Spontaneous spinal epidural hematoma is a rare neurosurgical condition that is often difficult to diagnose in the emergency department and can cause permanent neurological deficits if diagnosis is delayed or incorrect. We present the case of a 43-year-old man who was initially investigated for cardiac events, suspected posterior circulation stroke, or arterial dissection. All investigations were normal, which led us to perform magnetic resonance imaging of the brain, neck, and cervicothoracic spine, which revealed spontaneous spinal epidural hematoma. Publication of this case raises awareness of this rare neurosurgical emergency and the importance of differential diagnosis to avoid misdiagnosis in patients presenting with sudden-onset cervicothoracic back pain radiating to the upper limbs bilaterally with neurological deficit and a history of discectomy or receiving anticoagulants. Our study highlights the importance of early discussions with the consultant and specialty involvement in such cases.