J Korean Neurosurg Soc.  2013 Jul;54(1):68-70. 10.3340/jkns.2013.54.1.68.

Spontaneous Spinal Subdural Hematoma Concurrent with Cranial Subdural Hematoma

• Moon W
• Joo W
• Chough J
• Park H

• KMID: 2190865
• DOI: http://doi.org/10.3340/jkns.2013.54.1.68

Abstract

A 39-year old female presented with chronic spinal subdural hematoma manifesting as low back pain and radiating pain from both legs. Magnetic resonance imaging (MRI) showed spinal subdural hematoma (SDH) extending from L4 to S2 leading to severe central spinal canal stenosis. One day after admission, she complained of nausea and severe headache. Computed tomography of the brain revealed chronic SDH associated with midline shift. Intracranial chronic SDH was evacuated through two burr holes. Back pain and radiating leg pain derived from the spinal SDH diminished about 2 weeks after admission and spinal SDH was completely resolved on MRI obtained 3 months after onset. Physicians should be aware of such a condition and check the possibility of concurrent cranial SDH in patients with spinal SDH, especially with non-traumatic origin.

Keyword

Spinal subdural hematoma; Spontaneous; Brain herniation

MeSH Terms

Back Pain
Brain
Constriction, Pathologic
Female
Headache
Hematoma, Subdural
Hematoma, Subdural, Spinal
Humans
Leg
Low Back Pain
Magnetic Resonance Imaging
Nausea
Spinal Canal

Figure

• 

  Fig. 1 Findings of the initial MRI. An 8 cm long homogenous T1 slightly high (A) and well delineated lesion encircling thecal sac causing moderate to severe central spinal stenosis at L4-S2 level (B).

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  Fig. 2 Preoperative brain CT showing moderate amount of crescent-shaped heterogenous fluid collection on left cerebral convexity and midline shift to right side with compressed left lateral ventricle due to mass effect.

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  Fig. 3 Finding of postoperative brain CT and MRI. A : Postoperative brain CT shows complete disappearance of left subdural hematoma. B and C : Lumbar MRI taken 3 months later after diagnosis of the spinal SDH show complete resolution of hematoma. SDH : subdural hematoma.

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