Spinal Subdural Hematoma Research Articles

Delayed Diagnosis of a Ruptured Distal Posterior Inferior Cerebellar Artery (PICA) Dissecting Aneurysm Presenting as Craniocervical Junction and Spinal Subdural Hematoma

Delayed Diagnosis of a Ruptured Distal Posterior Inferior Cerebellar Artery (PICA) Dissecting Aneurysm Presenting as Craniocervical Junction and Spinal Subdural Hematoma

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

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

Contemporary Management Approaches for Spinal Subdural Hematoma in the Pediatric Population: Scoping Review

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

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

Spinal Subdural Hematoma in Ankylosing Spondylitis Patients Without Anticoagulation Therapy

Spinal Subdural Hematoma in Ankylosing Spondylitis Patients Without Anticoagulation Therapy

Post-traumatic spinal hematoma in diffuse idiopathic skeletal hyperostosis (DISH)

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

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

Spinal subdural hematoma in a patient with immune thrombocytopenic purpura following microvascular decompression: a rare case report.

This article reports a case of spontaneous spinal subdural hematoma (SSDH) after brain surgery in a patient with immune thrombocytopenic purpura (ITP), reviews the relevant literature, and discusses the etiology, pathogenesis, and clinical features of SSDH in patients with ITP. A male patient in his early 50 s with an 8-year history of ITP and suffering from coexistent hemifacial spasm and trigeminal neuralgia underwent microvascular decompression in our department. His preoperative corrected platelet count was within the normal range. On postoperative day 2, the patient complained of acute low back pain and sciatica. Lumbar magnetic resonance imaging demonstrated an SSDH extending from L3 to L4 with a significantly decreased platelet count (30.0 × 109/L). The pain was gradually relieved after 2 weeks of conservative treatment, and no neurological deficit occurred during the 1-year follow-up. Brain surgery may increase the risk of postoperative SSDH in patients with ITP. Clinicians planning brain surgery must conduct a rigorous assessment through detailed physical examination, laboratory tests, and medical history records and maintain perioperative platelet counts within the normal range to prevent various risks associated with spinal cord compression.

Acute Spinal Subdural Hematoma in a Patient With Multiple Spinal Aneurysms.

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

Spinal acute subdural hematoma following cerebrospinal fluid drainage during thoracoabdominal aortic aneurysm repair: Case report

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

Open Surgery for Osteoporotic Compression Fracture Within One Month of Single Level Balloon Kyphoplasty.

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.

Non-traumatic Spontaneous Spinal Subdural Hematoma in a Patient with Acute Paraplegia

Acute non-traumatic spinal subdural hematoma (SSDH) is a rare clinical condition in the emergency medicine practice and difficult to diagnose during the primary physical examination. It mostly occurs at thoracal vertebra levels due to trauma, use of anticoagulants, medical procedures such as acupuncture, arteriovenous malformations, hematological disorders or space-occupying lesions. Here, we discussed an elderly female patient who was not on anticoagulant and described sudden loss of muscle strength and sensation in both lower extremities. Initial laboratory and imaging including brain computerized tomography (CT) and magnetic resonance imaging (MRI) were in normal range. Her secondary examination revealed anesthesia under the T4 dermatome level. Cervical spine-MRI imaging revealed a subdural hematoma significantly compressing the spinal cord on the C7-T1 dermatome segments. Any emergency neurosurgical intervention was not considered and the patient was interned in the neurosurgical clinic for conservative treatment and further examination. Patient , with no progress seen in consecutive MRI scans, was discharged after offering an outpatient check-up. We recommend secondary physical examination in emergency department (ED). In the case of appearance of sensory deficits of certain dermatomes, spine-MR imaging may lead to put the diagnose early in ED.

Concomitant spontaneous spinal and posterior fossa subdural hematoma in an 11-year-old child with aplastic anemia: a case report and review of literature

PurposeThe current article describes an 11-year-old male who has aplastic anemia with an extremely rare condition, that is, concomitant posterior fossa SDH and spinal SDH.MethodsThis is a case report and review of literature.Case presentationThis case presents an 11-year-old male known to have aplastic anemia complained of neck and back pain, headache, and persistent vomiting for 3 days. He had no history of head or spine trauma at all. His parents are relatives “positive consanguinity,” and his sister suffers from aplastic anemia. Clinical examination revealed severe pallor at the time of presentation, with no neurologic or locomotor deficit and positive Kernig’s sign.ConclusionPatients with aplastic anemia or any bleeding disorder conditions should be investigated thoroughly if symptoms denoted a CNS pathology. Concomitant cranial and spinal SDH rarely occurs, and more studies are advocated to be structured to investigate the specific pathophysiology and etiologies of this condition.

Paraplegia after lumbar puncture

•Lumbar puncture is a very common and safe procedure. •Clopidogrel increased the risk of haemorrhage but serious side effect are rare. •Spinal subdural subarachnoid diffuse haematoma have been very rarely reported.

P.156 Spinal subdural hematoma from a type I spinal arteriovenous malformation: case report and literature review

Background: Type 1 spinal arteriovenous malformations (AVM) are dural fistulas which classically present due to progressive congestive myelopathy. Acute hemorrhage resulting in a spinal subdural hematoma is exceedingly rare with only three reported cases. Methods: This 46-year-old female experienced rapidly progressive paraplegia over several hours. There was no history of anti-coagulant use, trauma, fever, or infection. On examination, she had 0/5 in the lower extremities bilaterally and decreased sensation to pinprick below the T6 level on both sides. She also had loss of bowel and bladder control. MRI demonstrated evidence of an intra-dural extramedullary lesion located anteriorly causing significant compression on the spinal cord from T4 down to T7 level. Results: She underwent thoracic laminectomy from T4 – T7. After dural opening, a well organized sub-dural hematoma with significant mass effect on a distorted spinal cord was evacuated. Subsequently, a large abnormal artery leading into a dilated serpiginous vein on the dorsal aspect of spinal cord at the T7 level was visualized. Indocyanine green angiography confirmed our suspicion of a dural arteriovenous fistula which was disconnected. Conclusions: Type I spinal AVM in rare cases can present acutely as subdural hematoma and should be kept in the differential diagnosis for acute paraplegia.

Acute spontaneous spinal subdural hematoma presenting with Takotsubo cardiomyopathy: a rare case report and literature review.

Spontaneous spinal subdural hematoma (SSDH) is a rare and dangerous intraspinal hematoma that usually occurs in the thoracic vertebra. The influence of early cardiovascular changes secondary to spinal cord injury is an important emergent issue.Herein, we report a case of a middle-aged woman with clinical manifestations of back pain and motion and sensory disturbances below the level of spinal cord compression. During the disease course, she also developed changes indicative of myocardial injury, such as tachycardia, markedly increased concentrations of brain natriuretic peptide and cardiac troponin I, and a decreased left ventricular ejection fraction, which were consistent with the diagnosis of Takotsubo cardiomyopathy (TTC). After the administration of supportive therapies, the symptoms of myocardial injury rapidly resolved. With the absorption of SSDH, the symptoms and clinical signs were alleviated. We also reviewed the literature on cases of concomitant SSDH and TTC.This rare case broadens the symptom spectrum of SSDH and highlights the need for clinicians to be aware of concomitant SSDH and TTC. Initial conservative treatment is a viable option for SSDH with concomitant TTC. However, urgent surgery may be a better option if the SSDH progressively enlarges and causes spinal cord compression.

Whole-Spine MRI in Children With Suspected Abusive Head Trauma.

BACKGROUND. Abusive head trauma (AHT) in children has recently been associated with findings on cervical spine MRI. OBJECTIVE. The purpose of this study was to evaluate whether whole-spine MRI in children with suspected AHT shows additional abnormalities not identified on cervical spine MRI. METHODS. This retrospective study included 256 children younger than 3 years old (170 boys, 86 girls; mean age, 5.9 months) who underwent skeletal survey and head MRI for suspected child abuse from January 2019 to December 2020. Per institutional protocol, children with suspected AHT also underwent whole-spine MRI. AHT diagnoses were established by a combination of clinical information from medical record review and injuries described in reports from skeletal survey, head MRI, and head CT (if performed). Two pediatric neuroradiologists independently reviewed whole-spine MRI examinations for presence and level of intraspinal hemorrhage (classified as subarachnoid, subdural, or epidural), ligamentous injury, spinal cord edema, and vertebral fractures; subdural hematoma, epidural hematoma, ligamentous injury, and fracture unidentified by skeletal survey were considered major findings. Interobserver agreement was assessed; a third radiologist resolved discrepancies. Findings were summarized with attention to injuries isolated to the thoracolumbar spine. RESULTS. A total of 148 of 256 (57.8%) children underwent whole-spine MRI. AHT was diagnosed in 79 of 148 (53.4%) children who underwent whole-spine MRI versus in 2 of 108 (1.9%) who did not undergo whole-spine MRI (p < .001). Interobserver agreement, expressed as kappa coefficient, was 0.90 for intraspinal hemorrhage, 0.69 for ligamentous injury, 0.66 for spinal cord edema, and 0.95 for fracture. A total of 57 of 148 (38.5%) whole-spine MRI examinations showed injuries, and 34 of 148 (23.0%) showed injuries localized to the thoracolumbar spine. A total of 47 of 148 (31.8%) whole-spine MRI examinations showed major findings, of which 24 (51.1%) were localized to the thoracolumbar spine. Isolated thoracolumbar injuries included 23 of 34 spinal subdural hematomas, 2 of 3 spinal epidural hematomas, and 9 of 11 vertebral fractures, including five fractures not identified by skeletal survey. Diagnosis of AHT was more common in children with positive, versus negative, whole-spine MRI examinations (76.8% vs 39.1%; p < .001). CONCLUSION. In children with suspected AHT, whole-spine MRI commonly shows isolated thoracolumbar injuries. CLINICAL IMPACT. The results support performing whole-spine MRI rather than cervical spine MRI in children with suspected AHT.

Spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case.

BACKGROUNDPercutaneous vertebroplasty (PVP) is a common procedure, but cement leaks are not uncommon. Leakages do not always have consequences, but rarely complications do occur. Spinal subdural hematomas (sSDHs) are rare and even rarer presented as a complication after PVP. The best management for sSDH is, therefore, difficult to decide.OBSERVATIONSThe patient first received PVP for acute low back pain after falling. Cement leakages were noted after the procedure, but a sudden new-onset leg weakness only developed later. An emergency lumbar computed tomography scan showed cement leakages anterior to the dural sac; lumbar magnetic resonance imaging revealed a subdural spinal hematoma, and a decompressive laminectomy was performed. During the operation, a small cement mass in the shape of a horn was seen and was believed to have caused the sSDH. Postoperatively, the patient recovered to leg strength 5/5.LESSONSPVP is considered a low-risk procedure, and cement leaks rarely give rise to complications. However, when leakages present anterior to the dural sac, they may cause dural tear and possible sSDH, regardless of size. This possibility draws attention to keeping awareness of such rare but possible complications after routine PVP procedures. Timely intervention for sSDH is necessary to ensure meaningful recovery.

Spontaneous acute spinal subdural hematoma in patient on oral anticoagulant therapy

Introduction: Spontaneous spinal subdural hematoma as a result of coagulation deficit is a very rare and serious condition, with an overall incidence of less than 1%. Symptoms can vary according to the level of the bleed. Prompt recognition of the presence of spinal subdural hematoma is crucial for treatment. MRI is the investigation of choice for diagnosis as well as for planning the surgery. The differential diagnosis includes abscess, lipomatosis, significant discal hernia and tumours. There are no definite guidelines for the management of spinal subdural hematomas. In cases with serious neurological deficits, prompt surgical evacuation may lead to the resolution of symptoms and complete neurological recovery.&#x0D; Case report: We present a case of a 75-years-old man with bilateral lower limb radiculopathy, paresthesias, and spinal claudications for four days, progressing to bilateral paraplegia with urine incontinency. The patient was diagnosed with cauda equina syndrome due to spontaneous spinal subdural hematoma in the region from Th12 to L2. He was immediately operated and the subdural hematoma was evacuated. Minimal recovery was achieved and the patient was referred for further rehabilitation with severe paraparesis and urine incontinence.&#x0D; Conclusion: Early diagnosis of spinal subdural hematoma is essential for treatment. Any delay of correct diagnosis can lead to a devastating neurological deficit. Spontaneous spinal subdural hematoma is one of the rare conditions where an emergency MRI is indicated and crucial for diagnosis.

A case of treatment of acute spontaneous spinal subdural hematoma in a patient with the novel coronavirus COVID-19. Literature review

The aim of the work is to describe a case of spontaneous subdural spinal hematoma surgical treatment in a patient with a new coronavirus infection COVID-19, manifested by compression myeloradiculopathy. Materials and methods. In patient N., 70 years old, during the treatment of a new coronavirus infection COVID-19, signs of myelopathy from the dermatome level were revealed. Subdural hematoma was diagnosed at the Th7-L4 level with compression of the dural sac, ponytail and left spinal nerves at the Th12-L2 vertebral level. Results. Performed in the volume of decompressive laminectomy L1, removal of subdural hematoma with a good result in the form of restoration of spinal cord function. Early rehabilitation was carried out in the Department of neurosurgery. Conclusion. Spinal subdural hematomas are extremely rare. We have not found any reports of spinal hematomas in patients with COVID-19 in the Russian-language literature. Alertness to possible hemorrhagic complications in patients with a new coronavirus infection receiving anticoagulants, rapid diagnosis in a multidisciplinary hospital will allow timely neurosurgical care and achieve a good functional result.