Yonsei Med J.  2011 Jul;52(4):692-694. 10.3349/ymj.2011.52.4.692.

Treatment of Spontaneous Cervical Spinal Subdural Hematoma with Methylprednisolone Pulse Therapy

• Song TJ
• Lee JB
• Choi YC
• Lee KY
• Kim WJ

• KMID: 1728006
• DOI: http://doi.org/10.3349/ymj.2011.52.4.692

Abstract

We report herein a case of hyperacute onset of spontaneous cervical spinal subdural hematoma treated with methylprednisolone pulse therapy that showed good results. A 57-year-old man was admitted for posterior neck pain and paraparesis which occurred an hour ago. MRI revealed a ventral subdural hematoma distributed from the level of C1 down to T3, compressing the spinal cord. Conservative management with methylprednisolone pulse therapy was administered considering the patient's poor general condition. Although emergent surgical decompression is necessary in most cases of spinal subdural hematoma, conservative management with steroid therapy could be effective.

Keyword

Spinal subdural hematoma; pulse therapy; spinal cord

MeSH Terms

Cervical Vertebrae/pathology/radiography
Glucocorticoids/administration & dosage/*therapeutic use
Hematoma, Subdural, Spinal/*drug therapy/pathology/radiography
Humans
Magnetic Resonance Imaging
Male
Methylprednisolone/administration & dosage/*therapeutic use
Middle Aged
Paraparesis/drug therapy/pathology/radiography
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 (A) MR imaging taken two hours after the onset of symptoms shows subdural hematoma distributed from C1 to T3 as high signal intensity on T2 weighted image (arrows). (B) The hematoma is revealed as isointensity on T1 weighted image at the C1 to T3 levels (arrows).

• 

  Fig. 2 (A) CT imaging taken one month after the onset of symptoms shows subdural hematoma in C3 lesion (arrow). (B) The spinal cord at the C7 level is relatively intact.

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