Severe Mimic of Transverse Myelitis - Spontaneous Non-Traumatic Intramedullary Hematomyelia: A Case Report

This case report describes a rare instance of spontaneous intramedullary hematomyelia, a spinal cord hemorrhage, which mimicked transverse myelitis. A 55-year-old male presented with back pain, paraplegia, sensory loss, and incontinence. Initial diagnosis was transverse myelitis, but further imaging revealed hematomyelia. Despite treatment, the patient remained paraplegic, highlighting the need for early recognition and better therapies for vascular spinal cord pathologies.

• 1
  Spinal cord hemorrhage is a rare cause of acute myelopathy that can mimic other conditions, such as transverse myelitis.
• 2
  GRE sequences on MRI are critical for identifying hemorrhage within the spinal cord.
• 3
  The clinical course of hematomyelia can be devastating, leading to long-term disability despite aggressive treatment.