Spinal epidural hematoma (SEH) is an uncommon entity.
Chronic SEHs are rarer than acute SEHs.
May be caused by traumatic or nontraumatic conditions that include coagulopathy, vascular lesions and iatrogenic or idiopathic causes.
Yamao et al first reported a operative and histological observation of recurrent spontaneous spinal epidural hematoma caused by a posterior venous plexus 1)
In the presence of an epidural mass with clear clinical symptomatology, rare entities like chronic epidural hematoma or posterior migrated disk material should be always considered as a differential diagnosis in patients with suspicion of extradural chronic compressions. In these cases, only the intraoperatory and histopathological exams can provide a clear diagnosis 2).
A 2-year-old boy with a large spinal epidural hematoma resulting after an event of nonaccidental injury, specifically, domestic child abuse. This patient exhibited no focal neurological deficits and was managed conservatively without surgical clot evacuation. On a follow-up visit, repeat imaging studies demonstrated a stable resolution of spinal epidural hematoma, providing further support for the safety of conservative management in these patients 3)
Buvanendran et al. first reported a case of aspirin leading to an epidural hematoma following an interventional chronic pain procedure. Prior to interventional pain procedures, one should contemplate cessation of aspirin therapy because there are, at present, no consensus guidelines to direct such a decision 4).