Traumatic Spinal Subarachnoid Hemorrhage With Spinal Cord Compression: A Case Report and Literature Review

Area of Science:

• Neurosurgery
• Neuroradiology
• Spinal Cord Injury

Background:

• Spinal hematomas are rare, with challenging differentiation between subarachnoid and subdural hemorrhage on imaging.
• Traumatic spinal subarachnoid hemorrhage (SSAH) is uncommon and can cause severe neurological deficits.

Observation:

• A 53-year-old male presented with acute motor and sensory deficits in the left arm after a fall.
• MRI revealed an intradural hematoma at C4-C6 with significant spinal cord compression.
• Surgical exploration identified an arachnoid-enclosed hematoma.

Findings:

• Post-decompression, MRI showed resolution of spinal cord edema and confirmed left C6/C7 nerve root avulsion.
• Electromyography corroborated a brachial plexus avulsion.
• Nine months post-trauma and five months post-brachial plexus repair, significant left arm functional recovery was achieved.

Implications:

• Prompt evaluation for spinal cord compression, including intraspinal hematoma, is crucial for patients with neurological deficits after spinal trauma.
• Early spinal decompression can prevent irreversible neurological damage.
• This case demonstrates successful surgical decompression for traumatic SSAH and subsequent brachial plexus avulsion repair, avoiding postoperative myelopathy.