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Simultaneous cranial and spinal subdural hematoma.
Satoshi Yamaguchi1, Kaoru Kurisu, Kazunori Arita
1Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. satoya@hiroshima-u.ac.jp
Neurologia Medico-Chirurgica
|December 27, 2005
Summary
A patient with simultaneous cranial and spinal subdural hematomas (SDH) experienced mild leg symptoms. Both hematomas resolved spontaneously, suggesting spinal SDH may migrate from cranial sources.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Subdural hematomas (SDH) are typically cranial, but spinal involvement can occur.
- Simultaneous cranial and spinal SDH are rare, presenting diagnostic and therapeutic challenges.
Observation:
- A 59-year-old male presented with paraparesis and lower extremity numbness due to concurrent cranial and spinal subdural hematomas.
- Magnetic resonance (MR) imaging confirmed the simultaneous presence of both lesions.
- The patient had mild neurological symptoms and was treated conservatively due to poor medical condition.
Findings:
- Serial MR imaging demonstrated spontaneous resolution of both cranial and spinal SDHs within one month.
- Signal intensity changes on follow-up MR imaging indicated a degenerative process within the resolving hematomas.
- The findings suggest a potential migration of the spinal hematoma from the cranial lesion.
Implications:
- Spinal subdural hematoma (SDH) can be a delayed complication of chronic cranial SDH.
- Conservative management may be effective for spinal SDH in select patients with mild symptoms.
- This case highlights the importance of considering spinal involvement in patients with cranial SDH.