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Spinal subdural hematoma associated with traumatic intracranial interhemispheric subdural hematoma
Daisuke Wajima1, Hiroshi Yokota, Yuki Ida
1Department of Neurosurgery, Nabari City Hospital, Nabari, Mie, Japan. d-wajima@nabari-hospital.jp
Neurologia Medico-Chirurgica
|September 26, 2012
Summary
A fall caused a subdural hematoma, leading to leg weakness. Subsequent lumbar imaging revealed a spinal subdural hematoma, a key factor in the patient's persistent drop foot.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Subdural hematomas can arise from head trauma.
- Interhemispheric subdural hematoma (ISDH) is a rare type of intracranial bleeding.
- Spinal subdural hematoma (SSDH) is an uncommon condition, often associated with neurological deficits.
Observation:
- A 78-year-old female presented with left hemiparesis after head trauma and acute interhemispheric subdural hematoma (ISDH).
- Despite surgical intervention for ISDH, persistent leg monoparesis and drop foot were observed.
- Lumbar magnetic resonance imaging (MRI) revealed a spinal subdural hematoma (SSDH) at the S1-2 level, correlating with common peroneal nerve palsy.
Findings:
- Surgical decompression of the ISDH improved hemiparesis but not leg monoparesis.
- The presence of SSDH was identified as a significant contributor to the patient's persistent drop foot.
- Conservative management of SSDH and peroneal nerve palsy led to gradual improvement in motor function.
Implications:
- This case highlights the importance of considering concurrent spinal pathology in patients with head trauma and neurological deficits.
- Lumbar MRI is crucial for diagnosing SSDH in patients with posterior fossa subdural hematoma and subsequent leg palsy.
- Early diagnosis and appropriate management of SSDH can improve neurological outcomes and prevent long-term disability.
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