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[Wide-spread spontaneous spinal subarachnoid hematoma. Case report].
Neurologia Medico-Chirurgica
|January 1, 1990
Summary
A patient presented with sudden severe spinal pain and neurological deficits. Surgical removal of a spinal hematoma led to significant recovery, highlighting the importance of prompt intervention for spinal vascular events.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Spinal subarachnoid hemorrhage and hematomyelia are rare but serious conditions.
- Sudden onset of severe spinal pain can indicate a vascular emergency.
Observation:
- A 56-year-old female presented with acute, severe neck-to-back pain, altered consciousness, and neurological deficits including spastic paraparesis and urinary retention.
- Imaging revealed diffuse subarachnoid hematoma and hematomyelia from Th12 to L3.
- Spinal angiography failed to identify the source of the hemorrhage.
Findings:
- Surgical exploration identified an organized hematoma in the Th12-L1 subarachnoid space.
- Post-hematoma removal, non-pulsating tortuous vessels were noted on the spinal cord surface, extending intramedullarly.
- No definitive spinal arteriovenous malformation or fistula was identified.
Implications:
- Prompt surgical decompression and hematoma evacuation are crucial for managing spinal vascular emergencies.
- Despite unclear etiology, surgical intervention can lead to significant neurological recovery.
- This case underscores the diagnostic challenges and potential for recovery in spontaneous spinal hemorrhage.