Transient edema of the spinal cord as a result of spontaneous acute epidural hematoma in the thoracic spine

We present an unusual case of spontaneous epidural hemorrhage in the thoracic spine resulting in rapid onset of transient and extensive edema in the spinal cord. The patient presented with acute onset of midscapular back pain, bilateral lower extremity weakness, and bladder dysfunction. Repeat MRI 20 days after decompression of the hematoma showed residual hematoma and complete resolution of the spinal cord edema. The implications and differential diagnosis of spinal cord edema in this clinical setting are discussed.