BACKGROUND Spinal subarachnoid hemorrhage is unusual, and rarely resul
ts in spinal subarachnoid hematoma because the cerebrospinal fluid ten
ds to dilute the blood and prevent the formation of clots, We describe
a patient with spinal subarachnoid hematoma of unusual spontaneous or
igin. CASE A 66-year-old female presented with sudden onset of intense
back pain with paraplegia. Magnetic resonance imaging demonstrated a
mass lesion between T2 and T6, compressing the spinal cord anteriorly.
Emergency osteoplastic laminotomy exposed a hematoma in the subarachn
oid space from T2 to T6, but no source of the hemorrhage was found. Th
e patient was able to walk by herself about 20 days after the operatio
n. CONCLUSION The outcome is significantly influenced by the duration
between onset and operation, preoperative neurologic status, and rapid
ity of symptom progression. Therefore, we emphasize the importance of
early diagnosis, and rapid and complete operative removal of spinal su
barachnoid hematoma in order to achieve the best outcome.