Spontaneous spinal epidural hematoma (SSEH) is an uncommon cause of ac
ute nontraumatic myelopathy. We report a 14 year-old boy who had tetra
plegia on awakening. Diagnosis of spinal epidural hematoma was made by
magnetic resonance imaging. Despite spinal cord decompression within
9 h from onset, he remained tetraplegic. No cause for the bleeding was
found. The pathogenic hypotheses of SSEH are discussed and the import
ance of rapid diagnosis and treatment is emphasized.