Abstract
BACKGROUND
Spinal subdural hematoma (SDH) concomitant with cranial SDH is extremely rare. Although some theories have been proposed, the pathophysiology underlying this condition remains unclear. We present a case of traumatic subacute spinal SDH followed by symptomatic subacute cranial SDH.
CASE DESCRIPTION
A 56-year-old woman was admitted with severe back pain 2 weeks after sustaining a minor head injury. The pain was worse with walking or standing and was relieved a little bit by sitting. There was no clinical evidence of back injury. There was no neurologic deficit. Magnetic resonance imaging of the spine showed subacute spinal SDH from T12 to S1. Owing to progressive worsening of back pain, bilateral laminectomy of L1-S1 and drainage of subacute spinal SDH were performed. The pain was completely relieved after surgery. On postoperative day 4, the patient was noted to be unconscious with Glasgow Coma Scale score of 10 (E2V3M5). Computed tomography scan of the head showed subacute bilateral cranial SDH. Burr hole drainage was performed. The patient experienced a complete recovery.
CONCLUSIONS
This case suggests the possibility that spinal SDH can develop as a result of cranial SDH migration to the most dependent spinal subdural space. The physician should be aware of the possibility of symptomatic cranial SDH developing following spinal SDH evacuation.
TY - JOUR
T1 - Traumatic Subacute Spinal Subdural Hematoma Concomitant with Symptomatic Cranial Subdural Hematoma: Possible Mechanism.
AU - Golden,Nyoman,
AU - Asih,Made Widhi,
Y1 - 2018/12/24/
PY - 2018/09/03/received
PY - 2018/12/11/revised
PY - 2018/12/13/accepted
PY - 2018/12/28/pubmed
PY - 2019/4/2/medline
PY - 2018/12/28/entrez
KW - Concomitant
KW - Cranial subdural hematoma
KW - Gravity
KW - Spinal decompression
KW - Spinal subdural hematoma
SP - 343
EP - 347
JF - World neurosurgery
JO - World Neurosurg
VL - 123
N2 - BACKGROUND: Spinal subdural hematoma (SDH) concomitant with cranial SDH is extremely rare. Although some theories have been proposed, the pathophysiology underlying this condition remains unclear. We present a case of traumatic subacute spinal SDH followed by symptomatic subacute cranial SDH. CASE DESCRIPTION: A 56-year-old woman was admitted with severe back pain 2 weeks after sustaining a minor head injury. The pain was worse with walking or standing and was relieved a little bit by sitting. There was no clinical evidence of back injury. There was no neurologic deficit. Magnetic resonance imaging of the spine showed subacute spinal SDH from T12 to S1. Owing to progressive worsening of back pain, bilateral laminectomy of L1-S1 and drainage of subacute spinal SDH were performed. The pain was completely relieved after surgery. On postoperative day 4, the patient was noted to be unconscious with Glasgow Coma Scale score of 10 (E2V3M5). Computed tomography scan of the head showed subacute bilateral cranial SDH. Burr hole drainage was performed. The patient experienced a complete recovery. CONCLUSIONS: This case suggests the possibility that spinal SDH can develop as a result of cranial SDH migration to the most dependent spinal subdural space. The physician should be aware of the possibility of symptomatic cranial SDH developing following spinal SDH evacuation.
SN - 1878-8769
UR - https://www.unboundmedicine.com/medline/citation/30590215/Traumatic_Subacute_Spinal_Subdural_Hematoma_Concomitant_with_Symptomatic_Cranial_Subdural_Hematoma:_Possible_Mechanism_
DB - PRIME
DP - Unbound Medicine
ER -
