[Spontaneous extradural hematoma localized in the ventral side of the thoracic spinal cord--a case report]

A case of spontaneous spinal extradural hematoma was reported. The patient, a 25-year-old housewife, was hospitalized with back pain, followed by paralysis of both legs and urinary disturbance during next 2 hours. A myelogram demonstrated that contrast medium was incompletely blocked at the level from the 3rd to the 4th thoracic spine by extradural mass. Unfortunately X-ray CT scan was not examined, however, a NMR-CT scan excluded disc protrusion and dissecting aneurysm of the aorta. Eight hours after onset, wide laminectomy was performed as emergency operation and an epidural hematoma located in the ventral side with compression of the thoracic cord was removed as completely as possible. She was discharged with excellent recovery after operation. The spontaneous spinal epidural hematoma is rare emergency. The exact etiology is unknown, and no explanation is offered as to why the hematoma is usually dorsal in location. To our knowledge, only three cases of spinal epidural hematoma which located in the ventral side were reported. Considering from our experience and other reports, it seems to be the most important point to avoid the unnecessary pressure on the spinal cord and to search the exact bleeding point in the operative procedure of ventral epidural hematomas.