A Case of Acute Massive Spinal Subdural Hematoma With a Spot Sign on CT

Acute massive spinal subdural hematoma (ASSDH) is an extremely rare condition. We report a case of ASSDH in a 74-year-old woman who suddenly developed paraplegia after receiving oral anticoagulant therapy for severe back pain. Reported cases of ASSDH show various clinical presentations, ranging from low back pain to varying degrees of paralysis. In this case, the patient developed acute complete paraplegia. Despite undergoing emergency decompression surgery as soon as possible, the symptoms did not improve. Preoperative angiography revealed a "spot sign" originating from the radiculomedullary artery, suggesting the possibility of arterial dissection. This report mainly describes the preoperative and intraoperative findings of this rare case.