Abstract
BACKGROUND: Spontaneous spinal epidural hematomas (SSEHs) are a rare. Cervical SSEHs, though less common than thoracic or lumbar variants, pose a heightened risk of morbidity due to proximity to the brainstem and spinal cord making timely diagnosis treatment even more critical. CASE DESCRIPTION: A 50-year-old female presented with chronic neck pain for 1 week presented with the rapid onset of a progressive quadriparesis. The cervical magnetic resonance imaging revealed a posterior SSEH extending from C4 to T2, with maximal cord compression at C6-C7; the radiological differential diagnosis favored epidural hematoma versus tumor. She underwent an urgent decompressive laminectomy for evacuation of hematoma; pathology revealed no neoplasia or vascular malformation. Postoperatively, she recovered marked neurological motor function. CONCLUSION: Cervical SSEHs are rare and require immediate magnetic resonance diagnosis and surgical decompression to optimize neurological recovery.