Korean J Neurotrauma.  2019 Apr;15(1):34-37. 10.13004/kjnt.2019.15.e7.

Spontaneous Spinal Subdural and Subarachnoid Hemorrhage with Concomitant Intracerebral Hemorrhage: A Case Report

• Lee Y
• Lim J
• Han S
• Choi SW
• Youm JY
• Koh HS

• KMID: 2444203
• DOI: http://doi.org/10.13004/kjnt.2019.15.e7

Abstract

Most cases of spinal subdural hematoma are very rare and result from iatrogenic causes, such as coagulopathy or a spinal puncture. Cases of non-traumatic spinal subdural hematoma accompanied by intracranial hemorrhage are even more rare. There are a few reports of spontaneous spinal subdural hematoma with concomitant intracranial subdural or subarachnoid hemorrhage, but not with intracerebral hemorrhage. Especially in our case, the evaluation and diagnosis were delayed because the spontaneous intracerebral hemorrhage accompanying the unilateral spinal subdural and subarachnoid hemorrhages caused hemiplegia. We report a case of spinal subdural and subarachnoid hemorrhage with concomitant intracerebral hemorrhage, for the first time, with a relevant literature review.

Keyword

Intracranial hemorrhages; Hematoma; Subdural; Spinal

MeSH Terms

Cerebral Hemorrhage*
Diagnosis
Hematoma
Hematoma, Subdural, Spinal
Hemiplegia
Intracranial Hemorrhages
Spinal Puncture
Subarachnoid Hemorrhage*

Figure

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  FIGURE 1 (A) Noncontrast brain computed tomography showed acute intracerebral hemorrhage in the left side thalamus. (B) Brain magnetic resonance diffuse weighted image showed no acute cerebral infarction. Magnetic resonance image of (C) sagittal T2 weighted and (D) axial T2 weighted on the C5 level showed intradural acute hemorrhage extending from C3 to C6.

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  FIGURE 2 (A) Intraoperative photographic images under a microscope: after total laminectomy on C3-6, the dura and arachnoid membrane was longitudinally opened, which showed small CSF-mixed hematoma in subdural space and a dark blood color of hematoma in the subarachnoid space between the dorsal & ventral nerve roots of the right side 3rd to 6th cervical root and compressed spinal cord. (B) After total removal of hematoma, there was no specific bleeding focus, and the Dura was repaired after sufficient decompression of the hematoma.CSF: cerebrospinal fluid.

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