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Lumbar subdural hematoma from intracranial subarachnoid hemorrhage presenting with bilateral foot drop: case report.
Neurosurgery. 2011 Mar; 68(3):E835-9; discussion E839.N

Abstract

BACKGROUND AND IMPORTANCE

We report a patient with lumbar subdural hematoma secondary to intracranial subarachnoid hemorrhage (SAH) presenting with bilateral foot drop and describe our management.

CLINICAL PRESENTATION

A 37-year-old woman presented with grade 4 SAH and hydrocephalus requiring emergent external ventricular drainage. Angiography demonstrated a left vertebral artery dissection and pseudoaneurysm that was treated with embolization of the vertebral artery. Six days after admission, her neurologic examination significantly improved. She was awake, alert, following commands, and moving all her extremities normally except for bilateral foot drop. An MRI scan revealed a lumbar subdural hematoma with severe thecal sac compression at L4-S1. The patient was initially treated with expectant management followed by surgery after she demonstrated only modest improvement. Evacuation of the hematoma was undertaken by an L5-S1 laminectomy and drainage of the liquefied clot in the subdural, extra-arachnoid space. Postoperatively, the patient demonstrated improved strength in all muscle groups except for left lower extremity eversion.

CONCLUSION

We present a case of subdural hematoma that caused bilateral foot drop. Neurologic improvement occurred after evacuation of the hematoma.

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Authors+Show Affiliations

Waldron JS
Department of Neurological Surgery, University of California, San Francisco, California 94143, USA.
Oh MC
No affiliation info available
Chou D
No affiliation info available

MeSH

AdultDiagnosis, DifferentialFemaleGait Disorders, NeurologicHematoma, Subdural, SpinalHumansLumbar VertebraeSubarachnoid HemorrhageTreatment Outcome

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21311278

Citation

Waldron, James S., et al. "Lumbar Subdural Hematoma From Intracranial Subarachnoid Hemorrhage Presenting With Bilateral Foot Drop: Case Report." Neurosurgery, vol. 68, no. 3, 2011, pp. E835-9; discussion E839.
Waldron JS, Oh MC, Chou D. Lumbar subdural hematoma from intracranial subarachnoid hemorrhage presenting with bilateral foot drop: case report. Neurosurgery. 2011;68(3):E835-9; discussion E839.
Waldron, J. S., Oh, M. C., & Chou, D. (2011). Lumbar subdural hematoma from intracranial subarachnoid hemorrhage presenting with bilateral foot drop: case report. Neurosurgery, 68(3), E835-9; discussion E839. https://doi.org/10.1227/NEU.0b013e3182078099
Waldron JS, Oh MC, Chou D. Lumbar Subdural Hematoma From Intracranial Subarachnoid Hemorrhage Presenting With Bilateral Foot Drop: Case Report. Neurosurgery. 2011;68(3):E835-9; discussion E839. PubMed PMID: 21311278.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lumbar subdural hematoma from intracranial subarachnoid hemorrhage presenting with bilateral foot drop: case report. AU - Waldron,James S, AU - Oh,Michael C, AU - Chou,Dean, PY - 2011/2/12/entrez PY - 2011/2/12/pubmed PY - 2011/6/18/medline SP - E835-9; discussion E839 JF - Neurosurgery JO - Neurosurgery VL - 68 IS - 3 N2 - BACKGROUND AND IMPORTANCE: We report a patient with lumbar subdural hematoma secondary to intracranial subarachnoid hemorrhage (SAH) presenting with bilateral foot drop and describe our management. CLINICAL PRESENTATION: A 37-year-old woman presented with grade 4 SAH and hydrocephalus requiring emergent external ventricular drainage. Angiography demonstrated a left vertebral artery dissection and pseudoaneurysm that was treated with embolization of the vertebral artery. Six days after admission, her neurologic examination significantly improved. She was awake, alert, following commands, and moving all her extremities normally except for bilateral foot drop. An MRI scan revealed a lumbar subdural hematoma with severe thecal sac compression at L4-S1. The patient was initially treated with expectant management followed by surgery after she demonstrated only modest improvement. Evacuation of the hematoma was undertaken by an L5-S1 laminectomy and drainage of the liquefied clot in the subdural, extra-arachnoid space. Postoperatively, the patient demonstrated improved strength in all muscle groups except for left lower extremity eversion. CONCLUSION: We present a case of subdural hematoma that caused bilateral foot drop. Neurologic improvement occurred after evacuation of the hematoma. SN - 1524-4040 UR - https://www.unboundmedicine.com/medline/citation/21311278/Lumbar_subdural_hematoma_from_intracranial_subarachnoid_hemorrhage_presenting_with_bilateral_foot_drop:_case_report_ L2 - https://academic.oup.com/neurosurgery/article-lookup/doi/10.1227/NEU.0b013e3182078099 DB - PRIME DP - Unbound Medicine ER -