Korean J Spine.  2015 Sep;12(3):207-209. 10.14245/kjs.2015.12.3.207.

Migration of an Intracranial Subdural Hematoma to the Spinal Subdural Space: A Case Report

• Kwon OI
• Son DW
• Kim YH
• Kim YS
• Sung SK
• Lee SW
• Song GS

• KMID: 2288353
• DOI: http://doi.org/10.14245/kjs.2015.12.3.207

Abstract

A 57-year-old man complained of severe lower back pain and radicular pain in both legs for 1 week after falling from a ladder. Magnetic resonance imaging (MRI) of the spine showed a subdural hematoma (SDH), which was surgically removed. The patient had no back pain or the radicular leg pain at 2 weeks post-surgery. However, he complained of diffuse headaches upon follow-up. Brain computed tomography (CT) and MRI revealed an intracranial SDH, which was immediately removed by surgery. During his 1-year follow-up, he reported that the pain had resolved without recurrence. Simultaneous spinal and intracranial SDH are rare and no standard treatment exists for this condition. This case suggests that it is possible that an intracranial SDH can migrate into the cerebrospinal fluid (CSF) space through an arachnoid tear. CSF circulation allows the intracranial SDH to enter subarachnoid spaces encasing the spinal cord. In order to prevent irreversible damage, surgical intervention should be considered for case of spinal SDH with progressive neurological deficits.

Keyword

Cerebrospinal fluid; Intracranial subdural hematoma; Spinal subdural hematoma; Spinal injuries; Subarachnoid space

MeSH Terms

Arachnoid
Back Pain
Brain
Cerebrospinal Fluid
Follow-Up Studies
Headache
Hematoma, Subdural
Hematoma, Subdural, Intracranial*
Hematoma, Subdural, Spinal
Humans
Leg
Low Back Pain
Magnetic Resonance Imaging
Middle Aged
Recurrence
Spinal Cord
Spinal Injuries
Spine
Subarachnoid Space
Subdural Space*
Tears