[Spontaneous spinal subarachnoidal hematoma--case report (author's transl)]

Area of Science:

• Neurosurgery
• Neurology
• Spinal Cord Medicine

Background:

• Spontaneous intraspinal canal hematomas are uncommon neurological emergencies.
• These hematomas are categorized into epidural, subdural, and subarachnoid types.
• Subarachnoid hematomas within the spinal canal are exceptionally rare, with limited prior case reports.

Observation:

• A female patient presented with acute onset back pain, paraplegia, sensory deficits, and urinary retention.
• Lumbar puncture revealed bloody cerebrospinal fluid (CSF) and a complete spinal block.
• Myelography identified a filling defect at the T5 level, indicating a space-occupying lesion.

Findings:

• Surgical exploration via laminectomy revealed a subarachnoid hematoma spanning the T1-T5 vertebral levels.
• Complete surgical excision of the intraspinal subarachnoid hematoma was achieved.
• The underlying etiology of the hematoma remained unidentified.

Implications:

• This case underscores the critical need for prompt surgical intervention in patients with intraspinal canal hematomas.
• Early surgical decompression and hematoma evacuation are vital for neurological recovery, particularly in the presence of urinary retention.
• Further research into the etiology of spontaneous intraspinal subarachnoid hematomas may improve diagnostic and treatment strategies.