Spontaneous
spinal epidural hematoma is a rare condition defined by
bleeding in the epidural space of the spine with no identifiable causes such as
trauma,
vascular malformation, or
bleeding disorders. This is a case of a 79-year-old woman with a medical history of
diabetes mellitus,
dyslipidemia, and
hypertension presented with the sudden onset of severe thoracolumbar
back pain associated with weakness and
numbness in her bilateral lower limb. Examination of the lower limb showed bilateral lower limb motor and sensory deficits. Laboratory investigations showed normal results. MRI showed posterior extradural intraspinal
hematoma from T11 to L3 vertebrae. Patient underwent right hemilaminectomy and posterior
decompression of T12 and L1 vertebrae to evacuate the
hematoma. Postoperatively, her neurologic complications improved gradually. Decision was made not to restart
aspirin. On follow-up at 1 year, the patient had complete recovery of neurologic complications of both lower limb and had no recurrence of
bleeding. In short, this is a case of spontaneous
spinal epidural hematoma associated with long-term use of low-dose
aspirin in an elderly patient requiring surgical evacuation of
hematoma with good functional outcome after the surgery. Therefore,
aspirin should be prescribed cautiously especially to elderly patients.