Spinal Chronic Subdural Hematoma Mimicking Intradural Tumor in a Patient with History of Hemophilia A: Case Report

Abstract

A 22-year-old man with medical history of Hemophilia A was admitted with a 3-month history of low back pain radiating to the right leg. Neurological examination revealed no abnormalities. Spinal magnetic resonance imaging (MRI) with gadolinium enhancement revealed an intradural extramedullary mass at the level of L1 reported as an intradural tumor. The patient was operated after Factor VIII replacement. Intraoperatively, the lesion was found to be a pure subdural hematoma. The histopathological examination revealed pure chronic hematoma. Postoperatively the patient's complaints showed improvement and he was discharged with no complications. Although MRI is the gold standard of diagnosis for spinal intradural tumors, some mass lesions remain difficult to diagnose. Spinal chronic subdural hematoma should be considered in the differential diagnosis in these patients, especially in those with coagulopathies, even in the absence of a history of trauma.