Spontaneous Thoracic Epidural Hematoma Linked to Heavy Weight Lifting in a 29-Year-Old Male: A Case Report

Abstract

Background: Spontaneous spinal epidural hematoma (SSEH) is a rare and serious condition characterized by the accumulation of blood in the epidural space of the spine without any apparent cause. Although it is an uncommon clinical entity, SSEH can lead to acute neurological deficits and requires prompt intervention. This report explores the potential link between heavy lifting and the onset of SSEH in a young, otherwise healthy individual. Case Presentation: We present the case of a 29-year-old male who developed severe upper back pain following an episode of heavy lifting, which progressed to sudden paralysis. MRI revealed a thoracic epidural hematoma extending from T1 to T3, causing significant spinal cord compression. The patient underwent urgent posterior decompression surgery, which led to full neurological recovery within 24 hours. Discussion: This case underscores the potential for heavy lifting to trigger SSEH, a condition that can lead to rapid neurological decline. Early recognition, accurate diagnosis through MRI, and prompt surgical intervention are essential to prevent permanent damage and optimise patient outcomes. Conclusion: Physicians should consider SSEH in patients presenting with acute spinal cord symptoms following exertional activities like heavy lifting. Immediate intervention is crucial to ensure favourable outcomes in this rare but potentially devastating condition.