Spontaneous spinal epidural hematoma in an untreated hypertensive patient.

An insufficiently treated hypertensive woman developed severe neck pain, followed by a partial Brown-Sequard syndrome, due to a spontaneous spinal epidural hematoma compressing the cervical spinal cord at the levels C4-C7. We discuss the diagnostic difficulties in the acute setting and underline the importance of a careful and detailed neurological evaluation in all patients with any kind of acute neurological deficit. Application of modern imaging techniques in such selected acute cases is helpful in order to establish a diagnosis and initiate therapy. Although rare, clinicians should keep spinal epidural hematoma in mind and consider it as a highly uncommon, yet possible, complication of untreated hypertension.