{"id":"927ec127-eb17-4901-9fe1-996b478419df","slug":"spontaneous-intradural-extramedullary-hematoma-after-mild-exercise-in-von-willebrand-disease-a-rare-clinical-presentation-and-literature-review","title":"Spontaneous intradural extramedullary hematoma after mild exercise in Von Willebrand disease: A rare clinical presentation and literature review","authors":["Ali Bukhari","Apostolos Lagaras","Muhammad Dherijha","Asad Malik","Abbas Shahid"],"abstract":"Background: Von Willebrand disease (VWD) is the most common inherited bleeding disorder. Spinal intradural extramedullary hematoma (SIEH) is an exceptionally rare manifestation. Case Description: A 28-year-old woman with VWD developed spontaneous SIEH following mild exercise, presenting with back pain, progressive lower limb weakness, and double incontinence. Magnetic resonance imaging (MRI) demonstrated a T3/4 intradural extramedullary hematoma. Urgent surgical evacuation through T3/4 fenestration was performed, followed by targeted hemostatic therapy with recombinant von Willebrand factor (Vonicog Alfa). The patient made a complete neurological recovery within 3 months and remained asymptomatic at 14-month follow-up. Conclusion: SIEH should be considered in VWD patients presenting with acute spinal symptoms, even without trauma. Early MRI, prompt decompression, and tailored coagulation management are critical to optimal outcomes.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/927ec127-eb17-4901-9fe1-996b478419df/featured/hero-1781557430402.png","publishDate":"2026-06-05T00:00:00.000Z","doi":"10.25259/SNI_1357_2025","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2026/06/14605/SNI-17-335.pdf"}