Spontaneous spinal extradural hematoma in a child with hemophilia B, surgery or medical management - A dilemma?

Spontaneous spinal extradural hematoma is a rare clinical scenario which may be secondary to a variety of etiologies. Spinal epidural hematoma is an extremely rare complication in hemophiliacs. It usually runs an acute course often leading to rapid onset of neurological deficits. MR imaging is the diagnostic modality of choice and early, prompt treatment will often yield fruitful results. We report a case of spontaneous spinal EDH in a 5-year-old male child with Hemophilia B, who was managed conservatively and was doing well at last follow-up, 2 years after treatment. The authors discuss the role of factor replacement therapy vis-a-vis surgery in such a scenario.