Article Text

Rare disease
Acute spontaneous spinal subdural haematoma presenting as paraplegia and complete recovery with non-operative treatment
  1. Behçet Al1,
  2. Cuma Yildirim1,
  3. Suat Zengin1,
  4. Sinan Genc1,
  5. Ibrahim Erkutlu2,
  6. Ahmet Mete3
  1. 1
    Gaziantep University Hospital, Emergency Department, Medicine Faculty of Gaziantep University, Gaziantep, 27100, Turkey
  2. 2
    Gaziantep University Hospital, Neurosurgery, Department of Medicine Faculty, Gaziantep University, Gaziantep, 27100, Turkey
  3. 3
    Gaziantep University Hospital, Radiology, Department of Medicine Faculty, Gaziantep University, Gaziantep, 27100, Turkey
  1. Behçet Al, behcetal{at}


Spontaneous spinal subdural haematoma (SSDH) with no underlying pathology is a very rare condition. Only 20 cases have been previously reported. It can be caused by abnormalities of coagulation, blood dyscrasia, or trauma, underlying neoplasm, and arteriovenous malformation. It occurs most commonly in the thoracic spine and presents with sudden back pain radiating to the arms, legs or trunk, and varying degrees of motor, sensory, and autonomic disturbances. Although the main approach to management is surgical decompression, conservative management is used as well. We report the case of a 57-year-old man who presented with sudden severe low back pain followed by rapid onset of complete paraplegia. Magnetic resonance imaging (MRI) revealed an anterior subdural haematoma from T9 to L1 with cord compression. Corticosteroid treatment was administered. The patient showed substantial clinical improvement after 7 days of bed rest and an intense rehabilitation programme. An MRI scan and a computed tomography angiogram did not reveal any underlying pathology to account for the subdural haematoma.

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  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication