Spinal Subdural Hematoma Research Articles

Rationale:The co-occurrence of chronic subdural hematoma (CSDH) and spinal subdural hematoma (SSDH) is exceptionally rare, with ambiguous pathogenesis complicating management. This case aims to enhance understanding of its clinical trajectory, particularly the risk of intracranial progression after spinal surgery, which is critical for optimizing patient outcomes.Patient concerns:A 45-year-old woman presented with 3 days of severe lumbocrural pain and a 3-week history of headache after head trauma. She also reported 5 days of bowel dysfunction.Diagnoses:Lumbar magnetic resonance imaging revealed a lumbosacral SSDH (L2-S1). Cranial magnetic resonance imaging showed a right CSDH. Both hematomas were T1-isointense and T2-hyperintense without significant midline shift initially.Interventions:Oral atorvastatin (40 mg/day) was initiated for the CSDH. Emergency L4 hemilaminectomy for SSDH evacuation was performed due to intolerable pain and bowel dysfunction. On postoperative day 2, cranial CT showed CSDH progression with increased midline shift, prompting emergency burr-hole drainage.Outcomes:Lumbocrural pain resolved immediately postspinal surgery (visual analog scale: 9 to 2). Headache improved significantly postcranial drainage (numerical rating scale: 8 to 3). Bowel function normalized by discharge.Lessons:This case highlights that: SSDH can present with bowel dysfunction, a novel finding; postoperative intracranial hematoma progression is a real risk, necessitating vigilant neuroimaging surveillance after spinal evacuation; and the symptom sequence (cephalalgia preceding lumbalgia) supports the hematoma migration theory.

Concurrent spontaneous spinal and tentorial subdural hematomas in an older patient receiving anticoagulation treatment: a case report

Traumatic Isolated Lumbosacral Spinal Subdural Hematoma in a Pediatric Patient: A Case Report and Literature Review

Remote spinal subdural hematoma (SSH) following unilateral biportal endoscopic (UBE) spine surgery is rare, even without intraoperative dural injury. We report two such cases. A 76-year-old woman underwent anterior lumbar interbody fusion and UBE decompression for lumbar spinal stenosis. Intraoperatively, dense adhesions were noted, but no cerebrospinal fluid (CSF) leakage occurred. Postoperatively, she developed left leg monoplegia. MRI revealed a subdural hematoma at L2-3, remote from the surgical site. She recovered completely with steroid therapy and conservative management. An 88-year-old man underwent left-sided UBE laminotomy for central stenosis. The procedure was uneventful. Postoperative MRI revealed an incidental subdural hematoma from L2-4 without neurological deficits. He was observed conservatively. Both patients showed favorable outcomes without surgical evacuation. Remote SSH is a rare but important complication following UBE surgery. It should be considered when unexpected neurological deficits occur postoperatively, even in the absence of visible dural tears. Prompt diagnosis is essential for optimal management.

Spontaneous Spinal Subdural Hematoma―Comparative Analysis of Clinical Features, Time Course, and Outcomes with Epidural Hematoma―

Recurrent spinal subdural hematoma in granulomatosis with polyangiitis

Central nervous system vascular complications associated with the acute form of steroid-responsive meningitis-arteritis.

Recurrent spinal subdural hematoma in granulomatosis with polyangiitis.

The diagnosis of abusive head trauma (AbHT) in children is a challenging one that needs to be differentiated from natural disease and accidental head injury (AcHT). There is increasing evidence from the Neuroradiology field showing spinal cord injury in children subject to AbHT, which has, so far, been poorly investigated pathologically. In this study we retrospectively reviewed the forensic records of 110 paediatric head injury cases over an eight-year-period. The records included detailed circumstances of death and clinical history alongside neuropathology, ophthalmic pathology and osteo-articular pathology. Based on the final multidisciplinary agreement, the 110 case were grouped into AbHT (n = 40), AcHT (n = 9), not clearly accidental or abusive (“undetermined” (UHT) n = 8) and non-traumatic brain injury (NTBI, n = 53). The spinal cord pathology present within each group was compared. Spinal subdural haematoma (SDH) was present in 71% of AbHT and 50% of AcHT cases and were located predominantly at the thoracolumbar level. In AbHT cases without spinal SDH, the suspected mechanism of injury was that of head impact rather than shaking, whilst cases of AcHT with spinal SDH were associated with direct trauma to the spinal cord. Injury of spinal nerve roots in AbHT was almost three times that seen in the accidental head injury group (58% vs. 17%). The study shows that pathological examination of the spinal cord and spinal nerve roots is of high value in investigating AHT and may help in differentiating AbHT from AcHT.

Spinal subdural hematoma is a rare complication of lumbar puncture. It could be overlooked with devastating neurological consequences due to a delay in diagnosis. We report the case of 18 years-old woman followed for leukemia who presented a cauda equina syndrome after lumbar punctures for intrathecal chemotherapy. The Magnetic Resonance Imaging showed a thoraco-lumbar spinal subdural hematoma. The treatment consisted on a surgical evacuation of the hematoma after L2 laminectomy. On follow-up, the patient did not improve significantly. This observation shows that haemato-oncologists should be mindful of subdural hematoma as a possible complication of intrathecal chemotherapy and confirms the severity of the prognosis for late surgery.

Abstract Acute spinal subdural hematoma (ASSDH) is a rare complication following intrathecal chemotherapy; however, it has the potential to cause significant morbidity. We present the case of a child treated with intrathecal chemotherapy for acute myeloid leukemia. The child presented with pain and acute paralysis in the lower limbs a few hours after lumbar puncture. Radiological findings confirmed the presence of ASSDH. The child was operated on after correcting severe thrombocytopenia. Postoperatively, the patient experienced relief from pain; however, there was no noticeable improvement in motor deficit immediately, and postoperative imaging confirmed total evacuation of the hematoma, and intensive rehabilitation was prescribed. ASSDH is a rare complication of lumbar puncture that physicians should consider, especially in leukemic patients, after correcting all hemostasis parameters; diagnosis is based on clinical presentation and radiological findings, and management requires neurosurgical intervention.

Spinal Subdural Hematoma and Cauda Equina Syndrome Occurring After Interlaminar Injection in a Patient Receiving Anticoagulant Therapy

This scoping review study describes the assessment of articles relevant to the management of spinal subdural hematoma in the pediatric population. The assessment of the articles was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews guidelines. Of the 14 articles analyzed, the main focus was on management as well as evidence-based approaches in cases of pediatric spinal subdural hematoma. In the reviewed articles, various aspects related to intervention techniques, prevention strategies, and post-treatment follow-up were discussed. The findings of this review highlight the importance of a holistic and evidence-based approach in managing cases of spinal subdural hematoma in the pediatric population. The clinical implications of these findings may help improve medical understanding and practice in effectively managing this complex condition.

Spontaneous spinal subdural hematoma secondary to chronic warfarin intake: A case report

Patients with ankylosing spondylitis are at high risk of significant spinal trauma after relatively low-impact events, such as ground-level falls. Because of the osteopenic nature of the disease process, complex spinal fractures are common in these patients. Additionally, patients may sustain rare traumatic complications from these fractures, such as a spinal subdural hematoma (SSDH) or epidural hematoma. Traumatic SSDH is extremely rare, with few cases described in the literature, and cases are typically associated with antiplatelet or anticoagulant use. This study reviews the literature related to traumatic SSDH in patients with ankylosing spondylitis and describes two cases of traumatic SSDH in patients with ankylosing spondylitis without anticoagulation or antiplatelet therapy, which has not previously been reported in the literature.

ObjectivesTo determine the incidence of spinal hematoma and its relation to neurological deficit after trauma in patients with spinal ankylosis from diffuse idiopathic skeletal hyperostosis (DISH).Materials and methodsA retrospective review of 2256 urgent or emergency MRI referrals over a period of 8 years and nine months revealed 70 DISH patients who underwent CT and MRI scans of the spine. Spinal hematoma was the primary outcome. Additional variables were spinal cord impingement, spinal cord injury (SCI), trauma mechanism, fracture type, spinal canal narrowing, treatment type, and Frankel grades during injury, before and after treatment. Two trauma radiologists reviewed MRI scans blinded to initial reports.ResultsOf 70 post-traumatic patients (54 men, median age 73, IQR 66–81) with ankylosis of the spine from DISH, 34 (49%) had spinal epidural hematoma (SEH) and 3 (4%) had spinal subdural hematoma, 47 (67%) had spinal cord impingement, and 43 (61%) had SCI. Ground-level fall (69%) was the most common trauma mechanism. A transverse, AO classification type B spine fracture (39%) through the vertebral body was the most common injury type. Spinal canal narrowing (p < .001) correlated and spinal cord impingement (p = .004) associated with Frankel grade before treatment. Of 34 patients with SEH, one, treated conservatively, developed SCI.ConclusionsSEH is a common complication after low-energy trauma in patients with spinal ankylosis from DISH. SEH causing spinal cord impingement may progress to SCI if not treated by decompression.Clinical relevance statementLow-energy trauma may cause unstable spinal fractures in patients with spinal ankylosis caused by DISH. The diagnosis of spinal cord impingement or injury requires MRI, especially for the exclusion of spinal hematoma requiring surgical evacuation.Key Points• Spinal epidural hematoma is a common complication in post-traumatic patients with spinal ankylosis from DISH.• Most fractures and associated spinal hematomas in patients with spinal ankylosis from DISH result from low-energy trauma.• Spinal hematoma can cause spinal cord impingement, which may lead to SCI if not treated by decompression.

Spinal Subdural Hematoma Responsible for a Syndrome of the Tail of a Horse about a Case in the University Hospital Center of Guadeloupe and Review of Literature

HomeStrokeAhead of PrintAcute Spinal Subdural Hematoma in a Patient With Multiple Spinal Aneurysms No AccessCase ReportRequest AccessAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessCase ReportRequest AccessAcute Spinal Subdural Hematoma in a Patient With Multiple Spinal Aneurysms Mohamad Abdalkader, MD, Julie G. Shulman, MD, Anurag Sahoo, MD, Thomas Ford, MD and Thanh N. Nguyen, MD Mohamad AbdalkaderMohamad Abdalkader Correspondence to: Mohamad Abdalkader, MD, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118. Email E-mail Address: [email protected] https://orcid.org/0000-0002-9528-301X Department of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA. (M.A., T.N.N.) Search for more papers by this author , Julie G. ShulmanJulie G. Shulman Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA. (J.G.S., A.S., T.F., T.N.N.) Search for more papers by this author , Anurag SahooAnurag Sahoo https://orcid.org/0000-0001-7611-2832 Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA. (J.G.S., A.S., T.F., T.N.N.) Search for more papers by this author , Thomas FordThomas Ford https://orcid.org/0000-0002-2160-8248 Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA. (J.G.S., A.S., T.F., T.N.N.) Search for more papers by this author and Thanh N. NguyenThanh N. Nguyen https://orcid.org/0000-0002-2810-1685 Department of Radiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA. (M.A., T.N.N.) Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA. (J.G.S., A.S., T.F., T.N.N.) Neurosurgery, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA. (T.N.N.) Search for more papers by this author Originally published9 Feb 2023https://doi.org/10.1161/STROKEAHA.122.042120Stroke. 2023;0"Acute Spinal Subdural Hematoma in a Patient With Multiple Spinal Aneurysms." Stroke, , pp. –FootnotesThis manuscript was sent to Jean-Claude Baron, Guest Editor, for review by expert referees, editorial decision, and final disposition.For Sources of Funding and Disclosures, see page xxx.Correspondence to: Mohamad Abdalkader, MD, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118. Email mohamad.[email protected]org Previous Back to top Next FiguresReferencesRelatedDetails Advertisement Article InformationMetrics © 2023 American Heart Association, Inc.https://doi.org/10.1161/STROKEAHA.122.042120PMID: 36756890 Originally publishedFebruary 9, 2023 Keywordstomographyhematoma, subduralmagnetic resonance imaginganeurysmhemorrhagePDF download Advertisement SubjectsAneurysmMagnetic Resonance Imaging (MRI)Vascular Disease

During repair of abdominal aortic aneurysms, the risk of acute spinal cord injury secondary to decreased spinal perfusion rises up to 20%, thats why the lumbar cerebrospinal fluid drain has been used as a form of intra spinal pressure control and monitoring medullary perfusion pressure

This study aimed to analyze the reasons for open surgery performed within one month of balloon kyphoplasty (BKP) for osteoporotic compression fractures. This study included 15 patients treated with open surgery within one month of BKP in our institution from 2013 to 2020. Among them, 10 patients underwent BKP in our institution and 5 patients were transferred because of adverse events after undergoing BKP at another hospital. Clinical findings including main indications, neurological deficits, and clinical course were analyzed. All patients were followed up for at least 12 months after surgery (average time 15.5 months, range 12-39 months). Their mean age was 73.7 years and the mean T-score of the spine on bone densitometry was -3.35. The main reasons for open surgery included dislodgement of the cement mass or spinal instability (7 cases, 47%), neural injury due to cement leakage (3 cases, 20%), and spinal cord injury caused by a puncture mistake (3 cases, 20%). Two patients developed acute spinal subdural hematoma, and spinal epidural fluid was pushed out at the back edge of the vertebral body following BKP without signs of major cement leakage into the spinal canal. At the final follow-up, 7 patients with cement mass dislodgement showed complete improvement of related symptoms after posterior fusion with screw fixation. Among the 8 patients with neural injury, 6 improved; however, 2 remained at the same American Spinal Injury Association level. The main reasons for open surgery were cement mass dislodgement and neural injury caused by puncture errors or cement leakage into the spinal canal. It should be noted that proper selection of cases, detailed imaging evaluation, and optimal surgical techniques are key to reducing open surgery after BKP.