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Concomitant Intracranial Chronic Subdural Hematoma and Spinal Subdural Hematoma: A Case Report and Literature Review.
World Neurosurg. 2016 Jun; 90:706.e1-706.e9.WN

Abstract

BACKGROUND

Concomitant intracranial chronic subdural hematoma (CSDH) and spinal subdural hematoma (SDH) are rare, and the etiology has yet to be elucidated. However, migration of the hematoma intracranially to a spinal site or coincidence of both intracranial and spinal CSDHs have been proposed as etiologies. We report a case of concomitant intracranial CSDH and spinal SDH in which spinal hematoma might have migrated from the cranial lesion.

CASE DESCRIPTION

A previously healthy 58-year-old man with previous trauma to the occiput and lumbar spine suffered from headache, lumbago, and left hemiparesis. Head computed tomography revealed right-sided intracranial CSDH, and he underwent single burr-hole craniotomy. Although clinical symptoms tended to improve, left lower-limb weakness and lumbago remained. Spinal magnetic resonance imaging (MRI) 3 days after craniotomy revealed SDH extending from T1-S1. Because conservative therapy had not improved clinical symptoms, hematoma evacuation was performed via a left L5 hemilaminectomy 1 week after craniotomy. The patient showed complete recovery immediately postoperatively.

CONCLUSIONS

We reviewed the cases of 22 patients with concomitant intracranial CSDH and spinal SDH to discuss the features, etiology, and treatment strategy. Although surgical intervention was mainly selected for intracranial CSDH, conservative observation was mainly selected for spinal SDH. Outcomes were good in all patients. We created a new classification of spinal SDH shape using sagittal MRI. This classification indicates that cases with both ventral and dorsal SDH tend to require surgical intervention. This classification may help in deciding treatment strategies.

Authors+Show Affiliations

Department of Neurosurgery, Eisyokai Yoshida Hospital, Kobe, Japan. Electronic address: hiroaki-matsu@umin.ac.jp.Department of Neurosurgery, Eisyokai Yoshida Hospital, Kobe, Japan.Department of Neurosurgery, Eisyokai Yoshida Hospital, Kobe, Japan.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

26996734

Citation

Matsumoto, Hiroaki, et al. "Concomitant Intracranial Chronic Subdural Hematoma and Spinal Subdural Hematoma: a Case Report and Literature Review." World Neurosurgery, vol. 90, 2016, pp. 706.e1-706.e9.
Matsumoto H, Matsumoto S, Yoshida Y. Concomitant Intracranial Chronic Subdural Hematoma and Spinal Subdural Hematoma: A Case Report and Literature Review. World Neurosurg. 2016;90:706.e1-706.e9.
Matsumoto, H., Matsumoto, S., & Yoshida, Y. (2016). Concomitant Intracranial Chronic Subdural Hematoma and Spinal Subdural Hematoma: A Case Report and Literature Review. World Neurosurgery, 90, e1-e9. https://doi.org/10.1016/j.wneu.2016.03.020
Matsumoto H, Matsumoto S, Yoshida Y. Concomitant Intracranial Chronic Subdural Hematoma and Spinal Subdural Hematoma: a Case Report and Literature Review. World Neurosurg. 2016;90:706.e1-706.e9. PubMed PMID: 26996734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Concomitant Intracranial Chronic Subdural Hematoma and Spinal Subdural Hematoma: A Case Report and Literature Review. AU - Matsumoto,Hiroaki, AU - Matsumoto,Shigeo, AU - Yoshida,Yasuhisa, Y1 - 2016/03/18/ PY - 2016/01/01/received PY - 2016/03/08/revised PY - 2016/03/08/accepted PY - 2016/3/22/entrez PY - 2016/3/22/pubmed PY - 2017/8/31/medline KW - Chronic subdural hematoma KW - Headache KW - Lumbago KW - Magnetic resonance imaging KW - Spinal subdural hematoma SP - 706.e1 EP - 706.e9 JF - World neurosurgery JO - World Neurosurg VL - 90 N2 - BACKGROUND: Concomitant intracranial chronic subdural hematoma (CSDH) and spinal subdural hematoma (SDH) are rare, and the etiology has yet to be elucidated. However, migration of the hematoma intracranially to a spinal site or coincidence of both intracranial and spinal CSDHs have been proposed as etiologies. We report a case of concomitant intracranial CSDH and spinal SDH in which spinal hematoma might have migrated from the cranial lesion. CASE DESCRIPTION: A previously healthy 58-year-old man with previous trauma to the occiput and lumbar spine suffered from headache, lumbago, and left hemiparesis. Head computed tomography revealed right-sided intracranial CSDH, and he underwent single burr-hole craniotomy. Although clinical symptoms tended to improve, left lower-limb weakness and lumbago remained. Spinal magnetic resonance imaging (MRI) 3 days after craniotomy revealed SDH extending from T1-S1. Because conservative therapy had not improved clinical symptoms, hematoma evacuation was performed via a left L5 hemilaminectomy 1 week after craniotomy. The patient showed complete recovery immediately postoperatively. CONCLUSIONS: We reviewed the cases of 22 patients with concomitant intracranial CSDH and spinal SDH to discuss the features, etiology, and treatment strategy. Although surgical intervention was mainly selected for intracranial CSDH, conservative observation was mainly selected for spinal SDH. Outcomes were good in all patients. We created a new classification of spinal SDH shape using sagittal MRI. This classification indicates that cases with both ventral and dorsal SDH tend to require surgical intervention. This classification may help in deciding treatment strategies. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/26996734/Concomitant_Intracranial_Chronic_Subdural_Hematoma_and_Spinal_Subdural_Hematoma:_A_Case_Report_and_Literature_Review_ DB - PRIME DP - Unbound Medicine ER -