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[A case of hematoma in cisterna magna after mild head injury]
Y Kinoshita1, E Tsuru, H Yasukouchi
1Department of Neurosurgery, Munakata Suikokai General Hospital, Fukuoka, Japan.
Abstract:
An 18-year-old man suffered severe neck pain, signs of meningeal irritation, and dysesthesia of his left breast and left arm after mild head injury incurred in a traffic accident. On the next day, magnetic resonance imaging(MRI) revealed a hematoma in the cisterna magna, and it extended into the posterior spinal subdural space. Eight days after admission, MRI demonstrated the hematoma on the right posterior aspect of the spinal cord at the level of craniovertebral junction. These MRI findings suggested a ruptured bridging dorsal vein from the spinal cord to the occipital or marginal sinus. The usefulness of MRI for diagnosis of localized hematoma around the craniovertebral junction and the mechanism of this hemorrhage are discussed.
Insights
A mild head injury caused a spinal subdural hematoma in an 18-year-old man. Magnetic resonance imaging (MRI) diagnosed the rare condition, suggesting a ruptured vein near the craniovertebral junction.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Spinal subdural hematomas are rare, often resulting from trauma.
- Craniovertebral junction (CVJ) hematomas present unique diagnostic challenges.
Observation:
- An 18-year-old male experienced neck pain and neurological deficits post-mild head trauma.
- Initial MRI revealed a cisterna magna hematoma extending into the spinal subdural space.
- Follow-up MRI showed a hematoma at the CVJ, indicative of a ruptured venous sinus connection.
Findings:
- Magnetic resonance imaging (MRI) effectively diagnosed a localized CVJ hematoma.
- The hemorrhage was attributed to a ruptured bridging dorsal vein connecting the spinal cord to the occipital or marginal sinus.
- This case highlights a rare mechanism of spinal subdural hematoma formation.
Implications:
- MRI is crucial for diagnosing CVJ hematomas and understanding hemorrhage mechanisms.
- This case expands the understanding of traumatic CVJ hematoma etiology.
- Early diagnosis and characterization are vital for managing spinal CVJ hematomas.