Spontaneous cervico-thoracic epidural hematoma with spontaneously regressive paraplegia

Spontaneous spinal epidural hematoma is a rare condition that usually requi res surgical treatment in emergency. We report the unusual and well-documen ted case of a spontaneous spinal epidural hematoma, extending,from. C6 to T 2, occurring in a 56-year old man and causing paraplegia. Without surgery, the paraplegia spontaneously and completely recovered within the first 24 h ours. Serial MRI studies demonstrated the remitting course of the, spinal e pidural hematoma. Emergency surgical evacuation should still be the standar d treatment for patients with disabling and/or persistent neurologic defici t. A conservative approach tinder close neurologic observation may be recom mended for patients with no or mild deficits, for patients who show early a nd continuous clinical improvement within the first 24 hours and for patien ts with small and/or non-compressive spinal epidural hematoma. Reported cas es of spontaneous remission are very rare.