Traumatic subacute spinal subdural hematoma concomitant with symptomatic cranial subdural hematoma: the possibility of its mechanism.

Traumatic subacute spinal subdural hematoma concomitant with symptomatic cranial subdural hematoma: the possibility of its mechanism.

World Neurosurg. 2018 Dec 24;:

Authors: Golden N, Asih MW

Abstract
BACKGROUND: Spinal subdural hematoma (SDH) concomitant with cranial SDH is extremely rare. The pathophysiology underlying this condition remains unclear. Some theories have been proposed. The authors present a case of traumatic subacute spinal SDH followed by symptomatic subacute cranial SDH CASE DESCRIPTION: A 59-year-old female admitted with terrible back pain two weeks after minor head injury. The pain was getting worse when walking or standing and a little bit relieved by sitting. There was no clinical evidence of back injury. There was no neurological deficit. MRI of the spine showed subacute spinal SDH from T12 to S1. Due to the 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. However, on day 4, the patient was noted unconscious with GCS E2, V3, and M5. Head CT scan showed subacute bilateral cranial SDH. Burr hole drainage was performed. The patient was completely recovered.
CONCLUSIONS: Our case suggests the possibility that spinal SDH development as a result of cranial SDH migration to the most dependent spinal subdural space. The doctor should aware of developing symptomatic cranial SDH following spinal SDH evacuation.

PMID: 30590215 [PubMed - as supplied by publisher]

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