J Korean Neurosurg Soc.  2014 Sep;56(3):269-271. 10.3340/jkns.2014.56.3.269.

Acute Spontaneous Spinal Subdural Hematoma with Vague Symptoms

• Chung J
• Park IS
• Hwang SH
• Han JW

• KMID: 2339970
• DOI: http://doi.org/10.3340/jkns.2014.56.3.269

Abstract

Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of headache which we initially misdiagnosed as subarachnoid hemorrhage. In this case, the headache of patient improved but the neck pain persisted until hospital day 5. Therefre, we conducted the MRI of cervical spine and finally confirmed SSDH. The patient was managed conservatively and improved without recurrence. In this case report, we discuss the clinical features of SSDH with emphasis on the importance of an early diagnosis.

Keyword

Spinal subdural hematoma; Spontaneous; Diagnosis

MeSH Terms

Back Pain
Diagnosis
Early Diagnosis
Headache
Hematoma, Subdural, Spinal*
Humans
Magnetic Resonance Imaging
Neck Pain
Paraplegia
Paresis
Quadriplegia
Recurrence
Spine
Stroke
Subarachnoid Hemorrhage

Figure

• 

  Fig. 1 A and B : Sagittal and axial T2-weighted magnetic resonance image of the cervical spine demonstrating subdural hematoma on ventral side of the cord. C : Sagittal T2-weighted magnetic resonance image of the thoracic spine.

• 

  Fig. 2 Follow up sagittal T2-weighted magnetic resonance image of the thoracic spine demonstrating completely resolved hematoma.

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