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Spinal epidural haematoma (SEH) is a rare complication of haemophilia. A 3-month-old boy presenting with non-traumatic acute onset quadriparesis was found to have SEH on MRI scan. On further investigations, diagnosis of severe haemophilia A was confirmed. He responded well to conservative treatment with replacement of factor VIII without any need for surgical decompression. Neurological recovery was complete. We believe this is the youngest reported case of haemophilia presenting with spontaneous SEH. Another peculiarity of this case is absence of excessive bleeding due to forceps and vacuum application, circumcision and intramuscular injection, even in the presence of severe haemophilia. This case calls attention to the clinical features, radiological appearances and management options of this rare complication of SEH in people with haemophilia.

Haemophilia A presenting as spontaneous spinal epidural haematoma in a 3-month-old infant