PT  - JOURNAL ARTICLE
AU  - J Schröder
AU  - S Palkovic
AU  - H Wassmann
TI  - Spontaneous spinal epidural haematoma: a therapeutical challenge?
AID  - 10.1136/emj.2003.014027
DP  - 2005 May 01
TA  - Emergency Medicine Journal
PG  - 387--388
VI  - 22
IP  - 5
4099  - http://emj.bmj.com/content/22/5/387.short
4100  - http://emj.bmj.com/content/22/5/387.full
SO  - Emerg Med J2005 May 01; 22
AB  - We report the conservative treatment of a spontaneous spinal epidural haematoma attending with acute extensive neurological deficits, which resolved spontaneously. Spontaneous remission of spontaneous spinal epidural haematoma with severe neurological deficit is rare in the literature. An 80 year old man was admitted to our hospital presenting sciatica followed by rapid development of paraparesis and cauda equina syndrome, which represents a neurosurgical emergency. Magnetic resonance imaging revealed a multilevel epidural haematoma from L1 to L5. During the initial diagnostic procedure the symptoms started to decline unexpectedly, so the surgical intervention could be withdrawn. Twenty four hours after admission the patient was almost free of symptoms, mobile, and continent. Awareness and high index of suspicion, and a willingness to seek the prompt help of the imaging department, are crucial to successful management before the opportunity to treat is lost.