Spontaneous Spinal Epidural Hematoma with Initial Presentation Mimicking Aortic Dissection

Spontaneous spinal epidural hematoma (SSEH) is a rare cause of acute noutraumatic myelopathy. A 50-year-old man presented with sadden onset of severe hack pain wit/i radiation to the chest. Initially he had no neurologic dysfunction, hut he developed bilateral lower leg weakness one day after admission. The diagnosis was made by magnetic resonance imaging. An emergency decompressive leminectomy revealed a spinal epidural hematoma from C7 to T6, which may have been provoked by transient elevation of uncontrolled hypertension. The patient was discharged with improvement. The clinical picture of SSEH demonstrates a wide range of symptoms and it may be underestimated. Surgical intervention is still the mainstay of treatment. Early diagnosis and appropriate treatment are important for an optimal neurologic outcome.