Spontaneous spinal extradural hematomas

We review three patients who presented with acute spontaneous spinal extradural hematomas (SSEH). We discuss the presentation, imaging and management strategies. All three patients were adult women with thoracic SSEH. All had motor weakness prior to surgery. One patient recovered completely, one partially recovered and one did not recover. SSEH, although rare, should be considered in cases of acute onset paraparesis. The diagnostic modality of choice is magnetic resonance imaging. Favourable outcome is related to aetiology, interval between the ictus and presentation, and the severity of the neurological deficits. Emergent surgical drainage is the treatment of choice.