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Background: Spinal vascular malformations are rare. Intra-medullary cavernous haemangiomas are very rare and only few cases have been described. Occasionally they may cause pain, myelopathy with sensory or motor deficit due to mass effect or hemorrhage. Case Report: We report a patient who presented to the emergency department with acute retention of urine and lower limb weakness. He was diagnosed as a spinal intramedullary haematoma secondary to a cavernous haemangioma. In addition, multiple intracranial cavernous haemangiomas were found. Conclusions: We are of the opinion that our case of spinal intramedullary cavernous haemangioma with multiple intracranial involvements deserves attention due to its rarity and it is also an important reminder to examine the whole neuroaxis in patients with spinal intramedullary cavernous haemangiomas, regardless they are symptomatic or asymptomatic.