title: Complete motor recovery after acute paraparesis caused by spontaneous spinal epidural hematoma: case report.
abstract: BACKGROUND
  Spontaneous spinal epidural hematoma is a relatively rare but potentially disabling disease. Prompt timely surgical management may promote recovery even in severe cases.
  
  
  METHODS
  We report a 34-year-old man with a 2-hour history of sudden severe back pain, followed by weakness and numbness over the bilateral lower limbs, progressing to intense paraparesis and anesthesia. A spinal magnetic resonance imaging scan was performed and revealed an anterior epidural hematoma of the thoracic spine. He underwent an emergency decompression laminectomy of the thoracic spine and hematoma evacuation. Just after surgery, his lower extremity movements improved. After 1 week, there was no residual weakness and ambulation without assistance was resumed, with residual paresthesia on the plantar face of both feet. After 5 months, no residual symptoms persisted.
  
  
  CONCLUSIONS
  The diagnosis of spontaneous spinal epidural hematoma must be kept in mind in cases of sudden back pain with symptoms of spinal cord compression. Early recognition, accurate diagnosis and prompt surgical treatment may result in significant improvement even in severe cases.
authors.affiliation: Discipline of Emergency Medicine, Faculdade de Medicina da Universidade de São Paulo, Av, Dr, Enéas de Carvalho Aguiar 255, sala 5023, São Paulo, Brazil. leandrout@hotmail.com
authors.forename: Leandro U
authors.initials: LU
authors.lastname: Taniguchi
authors.forename: Felix H
authors.initials: FH
authors.lastname: Pahl
authors.forename: José E D
authors.initials: JE
authors.lastname: Lúcio
authors.forename: Roger S
authors.initials: RS
authors.lastname: Brock
authors.forename: Marcos Q T
authors.initials: MQ
authors.lastname: Gomes
authors.forename: Tarso
authors.initials: T
authors.lastname: Adoni
authors.forename: Victor C C
authors.initials: VC
authors.lastname: Fiorini
authors.forename: Rodrigo C
authors.initials: RC
authors.lastname: Carvalho
authors.forename: Eli F
authors.initials: EF
authors.lastname: Evaristo
authors.forename: Eduardo G
authors.initials: EG
authors.lastname: Mutarelli
authors.forename: Guilherme
authors.initials: G
authors.lastname: Schettino
mesh_terms: D000208:Acute Disease; D000328:Adult; D003937:Diagnosis, Differential; D046748:Hematoma, Epidural, Spinal / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D020335:Paraparesis / Q000175:diagnosis* / Q000209:etiology; D013904:Thoracic Vertebrae