Spontaneous idiopathic cervical spinal epidural hematoma mimicking tumor: A case report

Spontaneous spinal epidural hematomas (SSEHs) are a rare. Cervical SSEHs, though less common than thoracic or lumbar variants, pose a heightened risk of morbidity due to proximity to the brainstem and spinal cord making timely diagnosis treatment even more critical.

A 50-year-old female presented with chronic neck pain for 1 week presented with the rapid onset of a progressive quadriparesis. The cervical magnetic resonance imaging revealed a posterior SSEH extending from C4 to T2, with maximal cord compression at C6-C7; the radiological differential diagnosis favored epidural hematoma versus tumor. She underwent an urgent decompressive laminectomy for evacuation of hematoma; pathology revealed no neoplasia or vascular malformation. Postoperatively, she recovered marked neurological motor function.

Cervical SSEHs are rare and require immediate magnetic resonance diagnosis and surgical decompression to optimize neurological recovery.