Severe lumbar stenosis caused by chronic spinal epidural hematoma and multiple disk disease--case report and review of the literature.

We present a patient whose radicular syndrome resulted from combined compression by disk herniation and lumbar chronic spinal epidural hematoma (CSEH). The lesion was extensively studied by CT and MRI and the preoperative diagnosis confirmed by microscopic examination. CSEH is a rare entity, typical of elderly and invariably involving the lumbar canal: only 11 similar cases have been reported up to date. We propose that an undefined number of CSEH remains clinically silent, hidden in the roomy lumbar canal, displacing but not injuring the roots of the cauda. The routine use of Gd-DTPA MRI, even in emergency, will significantly decrease mistakes localization and will provide the correct differential diagnosis.