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Do cranial subdural hematomas migrate to the lumbar spine?
S Moscovici1, I Paldor, F Ramirez de-Noriega
1Department of Neurosurgery, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.
Summary
A patient developed spinal subdural hematoma (SDH) after head trauma, presenting as delayed leg weakness. Prompt diagnosis and surgical drainage of the lumbar spine SDH led to symptom improvement.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Subdural hematoma (SDH) typically occurs after head trauma.
- Delayed neurological deterioration following head trauma can have various causes.
Purpose of the Study:
- To report a rare case of delayed spinal subdural hematoma following traumatic brain injury.
- To highlight the importance of considering spinal SDH in patients with neurological decline after head trauma.
Main Methods:
- Case report of an 88-year-old male with minor head trauma.
- Initial diagnosis of hemispheric subdural hematoma (SDH) via Head CT.
- Subsequent diagnosis of lumbar spinal SDH using CT and MRI, followed by surgical decompression.
Main Results:
- Patient presented with acute confusion and was diagnosed with bilateral hemispheric SDH.
- Developed delayed leg weakness attributed to a lumbar spinal subdural hematoma.
- Surgical drainage of the spinal SDH resulted in improvement of lower extremity weakness.
Conclusions:
- Traumatic brain injury can be complicated by delayed spinal subdural hematoma.
- Neurological deterioration in patients with a history of traumatic SDH warrants evaluation for spinal involvement.
- Early recognition and intervention for spinal SDH are crucial for favorable outcomes.
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