Spontaneous Epidural Hematomas in a Patient With Sickle Cell Anemia: A Case Report

Sickle cell disease (SCD) is a systemic organ disease with acute and chronic complications. Neurological complications of SCD include cerebral ischemia, moyamoya syndrome, posterior reversible encephalopathy syndrome, cerebral fat embolism, and cerebral venous sinus thrombosis. Although less frequent, rare hemorrhagic manifestations, such as spontaneous epidural hematoma (EDH), can occur and are associated with increased mortality and morbidity. Herein, we present a case of a 20-year-old male with SCD who developed a massive, bilateral EDH without a history of trauma. MRI revealed ischemic bone changes associated with the hematoma, suggesting bone infarction as the underlying mechanism. This case highlights the importance of considering hemorrhagic complications in the differential diagnosis of SCD patients with acute neurological symptoms, even in the absence of a recent vaso-occlusive crisis.