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Spontaneous chronic spinal subdural hematoma associated with spinal arachnoiditis and syringomyelia

F Siddiqi1, R Hammond, D Lee

  • 1Departments of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|December 6, 2005
PubMed

Insights

Spontaneous chronic spinal subdural hematoma, a rare condition, can occur with arachnoiditis and syringomyelia. This case highlights a 76-year-old woman with a 14-year history of myelopathy, successfully treated with surgery.

Area of Science:

  • Neurosurgery
  • Neurology
  • Pathology

Background:

  • Spontaneous chronic spinal subdural hematoma (CSDH) is an uncommon neurological condition.
  • CSDH can present with progressive myelopathy, mimicking other spinal cord pathologies.
  • Association with arachnoiditis and syringomyelia is rarely reported.

Observation:

  • A 76-year-old woman presented with a 14-year history of progressive myelopathy.
  • Magnetic Resonance Imaging (MRI) revealed a thoraco-lumbar subdural cystic lesion and a thoracic syrinx.
  • Surgical intervention included laminectomy, decompression of the subdural hematoma, and myelotomy for syrinx drainage.

Findings:

  • Pathological examination confirmed a chronic subdural membrane.
  • Surgical decompression and syrinx drainage led to clinical improvement.
  • The case provides insight into the pathogenesis of spinal subdural hematoma and syrinx formation.

Implications:

  • This case underscores the importance of considering CSDH in patients with chronic myelopathy.
  • Understanding the pathogenesis may aid in earlier diagnosis and treatment of CSDH and associated syringomyelia.
  • Further research into etiological factors is warranted to elucidate the development of CSDH.

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