Spinal epidural hematoma as first presentation of hemophilia A

We describe a case of spinal epidural hematoma in a 12-year-old boy, who presented with the clinical triad of localized spine pain, radicular pain, and weakness. The lesion occurred as the first manifestation of a mild Factor VIII deficiency in a patient who was not previously diagnosed with hemophilia A. Early recognition of this condition and appropriate treatment with Factor VIII is imperative, along with neurosurgical consultation. It can make the difference in outcome between recovery and severe, persistent sequelae.