A delayed-onset intracranial chronic subdural hematoma following a lumbar spinal subdural hematoma

Abstract

Rationale:A spinal subdural hematoma (SDH) is rarely complicated with an intracranial SDH. We found only 7 cases of spontaneous concurrent lumbar spinal and cranial SDHs, in which lumbar symptoms occurred before head symptoms.Patient concerns:We describe a 77-year-old man with spontaneous concurrent spinal and cranial SDHs, in whom the spinal SDH was identified 30 days before the intracranial chronic SDH.Diagnosis:Magnetic resonance imaging showed a spinal SDH at L4/L5. There was no paralysis, and the patient was managed conservatively. About 30 days after the onset of back pain, he experienced tinnitus and visual hallucination. Brain computed tomography showed a chronic SDH and midline shift.Interventions:Burr-hole evacuation was performed, and the patient's condition improved.Outcomes:At 5 months of follow-up, there was no recurrence of the spinal or intracranial SDH.Lessons:It is important to consider the possibility of intracranial hemorrhage when a spinal SDH is identified.