Spontaneous epidural hematoma of the thoracic spine in a 17-year-old adolescent boy: a case report.

Spontaneous spinal epidural hematoma is a rare cause of spinal cord compression. Symptoms typically include a sudden onset of back pain followed by neurologic deterioration including weakness, numbness, and incontinence. We report the case of a 17-year-old adolescent boy who presented to the emergency department with acute onset of back pain that woke him from sleep, progressing to paralysis and anesthesia of lower extremities, accompanied by priapism. Magnetic resonance imaging (MRI) demonstrated an epidural hematoma of the thoracic spine with spinal cord compression. The patient was taken to the operating room for decompression laminectomy where they discovered a thrombosed dural arteriovenous fistula. Postoperative angiography shows no residual lesions. Emergency physicians see many patients with back pain and should be clinically suspicious of spontaneous spinal epidural hematomas to reduce morbidity and mortality.