Spontaneous spinal epidural hematoma (SEH) is a rare but
serious clinical condition characterized by the accumulation of blood in the
spinal epidural space, often leading to acute neurological deficits due to
spinal cord compression. This case report presents a 76-year-old female with
lumbar pain and progressive lower limb weakness, diagnosed with SEH. Magnetic
resonance imaging revealed an epidural hematoma compressing the spinal cord.
Despite being on rivaroxaban for atrial fibrillation, no coagulation
abnormalities were detected. Surgical intervention with laminotomy and hematoma
evacuation led to significant neurological recovery. The case highlights the
importance of early diagnosis and intervention in SEH management to prevent
permanent neurological deficit and improve outcomes. This report also compares
the clinical findings and treatment approaches with existing literature,
providing insights into the optimal management of SEH.
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