Spontaneous dorsal epidural haematoma: usefulness of magnetic resonance imaging and importance of operative treatment even in cases with complete paraplegia.

Spontaneous epidural haematomas are rare at any level of the spinal canal. The radiological diagnosis is usually made by myelography and in a few reported cases by computed tomography (CT). We describe a patient in which the final diagnosis was possible only with Magnetic Resonance Imaging (MRI). Surgical evacuation resulted in partial recovery of an already four days existing complete paraplegia. It is stressed that MRI is the most useful examination to differentiate haematomas from other spinal epidural lesions and that an operative evacuation of a spinal epidural haematoma is indicated even if the patient comes after a complete paraplegia has developed.