Korean J Spine.  2012 Sep;9(3):257-260. 10.14245/kjs.2012.9.3.257.

Spontaneous Resolution of Non-traumatic Cervical Spinal Subdural Hematoma Presenting Acute Hemiparesis: A Case Report

• Park YJ
• Kim SW
• Ju CI
• Wang HS

• KMID: 2288490
• DOI: http://doi.org/10.14245/kjs.2012.9.3.257

Abstract

Spontaneous cervical SDH with no underlying pathology is a very unusual condition. To the best of the authors' knowledge, only two cases have been previously reported. A 48-year-old female patient was admitted to our emergency room due to severe neck pain following standing up position with rapid onset of hemiparesis. MRI revealed a dorsolateral subdural hematoma from C3-C5 with cord compression. An emergency laminectomy was planned, but motor weakness gradually improved during surgical preparation. The patient showed substantial clinical improvement and complete recovery was confirmed after 7 days of conservative management without surgical treatment. To determine a differential diagnosis distinct from other conditions such as cervical epidural hematoma, a lumbar spinal puncture was performed. Follow-up MRI performed 10 days after admission revealed complete resolution of the hematoma. We report an extremely rare case of spontaneous cervical spinal subdural hematoma (SDH), present a review of relevant literature, and discuss the etiology, pathogenesis, and prognosis of this case.

Keyword

Cervical; Spontaneous; Subdural hematoma

MeSH Terms

Diagnosis, Differential
Emergencies
Female
Follow-Up Studies
Hematoma
Hematoma, Subdural
Hematoma, Subdural, Spinal
Humans
Laminectomy
Middle Aged
Neck Pain
Paresis
Prognosis
Spinal Puncture