Spontaneous spinal epidural haematoma (SSEDH) is an uncommon condition presenting with local and radicular pain associated with clinical features of rapidly progressive spinal cord compression. The cause of the bleeding is varied, with anticoagulant therapy recognised to be the commonest known aetiological factor.1 Surgery is the preferred treatment, regardless of aetiology, especially in patients with extensive haematomas and neurological deficits.1 2 Spontaneous resolution of the haematoma is reported but rare.3-5 We report a case of an extensive spontaneous spinal epidural haematoma extending from the upper cervical to lower thoracic region secondary to anticoagulant therapy, with remarkable clinical and radiological improvement with conservative management.

An 82 year old woman was admitted with a one week history of neck pain and upper thoracic pain, which had worsened during the preceding 4 days. On the day before admission, she developed sudden onset of complete paraplegia with urinary retention. She had noticed some improvement in power in her legs and back pain on the day of referral to our institution. She has a medical history of ischaemic heart disease with congestive cardiac failure and …