Simultaneous occurrence of epidural, subdural, and subarachnoid hemorrhages in the spinal canal: a rare case report

Simultaneous spinal epidural, subdural, and subarachnoid hemorrhages are exceedingly rare, with no prior documented case of all three occurring simultaneously in the literature. We present the case of a 59-year-old woman who developed acute lower back pain and progressive weakness in her lower extremities. MRI revealed three distinct types of hemorrhages: an epidural hematoma extending from T12 to the lumbar spine, a subdural hematoma between T11 and S1, and a subarachnoid hemorrhage involving the cauda equina. Surgical decompression was performed, leading to significant clinical improvement. This case underscores the critical role of MRI in the diagnosis of complex spinal hematomas and highlights the importance of prompt surgical intervention to prevent further neurological deterioration. Our report contributes valuable insights into the management of multifaceted spinal hemorrhages, emphasizing the need for early recognition and treatment in such rare presentations.