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Acute Compressive Myelopathy Caused by Spinal Subarachnoid Hemorrhage: A Combined Effect of Asymptomatic Cervical Spondylosis.
World Neurosurg. 2016 Nov; 95:619.e1-619.e4.WN

Abstract

BACKGROUND

Patients with subarachnoid hemorrhage (SAH) by hemorrhagic arteriovenous fistulas (AVFs) usually presents with meningeal signs, including headache and nausea, and focal neurologic deficit is found in rare cases. In this article, we report a case of acute compressive cervical myelopathy caused by hemorrhagic AVF at the craniocervical junction.

CASE DESCRIPTION

A 73-year-old woman was transferred to our hospital for sudden headache and subsequent left hemiparesis. Head computed tomography scan showed SAH exclusively in the posterior fossa, and catheter angiography revealed a perimedullary arteriovenous fistula at the craniocervical junction as a source of the SAH. Detailed neurologic examination showed the sensory disturbance of bilateral upper extremities and bladder and rectal disturbance, suggesting concurrent cervical myelopathy. Magnetic resonance imaging of the cervical spine showed disk herniation at the C4-5 level, spinal SAH deposition above the C4-5 level, and accompanying myelomalacia. No intramedullary hemorrhage was found.

CONCLUSIONS

Spinal SAH alone rarely causes focal neurologic deficit. However, this case suggests spinal SAH can cause acute compressive myelopathy when complicated with preexisting spinal canal stenosis.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan. Electronic address: toshi821@kuhp.kyoto-u.ac.jp.

Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.

Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.

Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.

Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.

Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.

MeSH

AgedAngiography, Digital SubtractionArteriovenous FistulaCerebral AngiographyCervical VertebraeFemaleHumansIntervertebral Disc DisplacementIntracranial Arteriovenous MalformationsMagnetic Resonance ImagingSpinal CordSpinal Cord CompressionSpondylosisSubarachnoid HemorrhageTomography, X-Ray Computed

Pub Type(s)

Case Reports

Journal Article

Language

eng

PubMed ID

27567572

Citation

Kawasaki, Toshinari, et al. "Acute Compressive Myelopathy Caused By Spinal Subarachnoid Hemorrhage: a Combined Effect of Asymptomatic Cervical Spondylosis." World Neurosurgery, vol. 95, 2016, pp. 619.e1-619.e4.

Kawasaki T, Fukuda H, Kurosaki Y, et al. Acute Compressive Myelopathy Caused by Spinal Subarachnoid Hemorrhage: A Combined Effect of Asymptomatic Cervical Spondylosis. World Neurosurg. 2016;95:619.e1-619.e4.

Kawasaki, T., Fukuda, H., Kurosaki, Y., Handa, A., Chin, M., & Yamagata, S. (2016). Acute Compressive Myelopathy Caused by Spinal Subarachnoid Hemorrhage: A Combined Effect of Asymptomatic Cervical Spondylosis. World Neurosurgery, 95, e1-e4. https://doi.org/10.1016/j.wneu.2016.08.031

Kawasaki T, et al. Acute Compressive Myelopathy Caused By Spinal Subarachnoid Hemorrhage: a Combined Effect of Asymptomatic Cervical Spondylosis. World Neurosurg. 2016;95:619.e1-619.e4. PubMed PMID: 27567572.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Acute Compressive Myelopathy Caused by Spinal Subarachnoid Hemorrhage: A Combined Effect of Asymptomatic Cervical Spondylosis. AU - Kawasaki,Toshinari, AU - Fukuda,Hitoshi, AU - Kurosaki,Yoshitaka, AU - Handa,Akira, AU - Chin,Masaki, AU - Yamagata,Sen, Y1 - 2016/08/25/ PY - 2016/05/12/received PY - 2016/08/07/revised PY - 2016/08/08/accepted PY - 2016/8/29/pubmed PY - 2017/10/3/medline PY - 2016/8/29/entrez KW - Arteriovenous fistula KW - Cervical spondylosis KW - Myelopathy KW - Perimedullary KW - Spinal subarachnoid hemorrhage SP - 619.e1 EP - 619.e4 JF - World neurosurgery JO - World Neurosurg VL - 95 N2 - BACKGROUND: Patients with subarachnoid hemorrhage (SAH) by hemorrhagic arteriovenous fistulas (AVFs) usually presents with meningeal signs, including headache and nausea, and focal neurologic deficit is found in rare cases. In this article, we report a case of acute compressive cervical myelopathy caused by hemorrhagic AVF at the craniocervical junction. CASE DESCRIPTION: A 73-year-old woman was transferred to our hospital for sudden headache and subsequent left hemiparesis. Head computed tomography scan showed SAH exclusively in the posterior fossa, and catheter angiography revealed a perimedullary arteriovenous fistula at the craniocervical junction as a source of the SAH. Detailed neurologic examination showed the sensory disturbance of bilateral upper extremities and bladder and rectal disturbance, suggesting concurrent cervical myelopathy. Magnetic resonance imaging of the cervical spine showed disk herniation at the C4-5 level, spinal SAH deposition above the C4-5 level, and accompanying myelomalacia. No intramedullary hemorrhage was found. CONCLUSIONS: Spinal SAH alone rarely causes focal neurologic deficit. However, this case suggests spinal SAH can cause acute compressive myelopathy when complicated with preexisting spinal canal stenosis. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/27567572/Acute_Compressive_Myelopathy_Caused_by_Spinal_Subarachnoid_Hemorrhage:_A_Combined_Effect_of_Asymptomatic_Cervical_Spondylosis_ DB - PRIME DP - Unbound Medicine ER -