A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis
A 76-year-old woman with a spinal subdural hematoma (SDH) was presented with severe back pain without headache. Magnetic resonance imaging (MRI) performed 4 days after onset showed SDH extending from Th2 to L3. She was diagnosed with spontaneous SDH without neurological manifestation, and conservati...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2019/7384701 |
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| author | Taihei Go Toshiyuki Tsutsui Yasuaki Iida Katsunori Fukutake Ryoichi Fukano Kosei Ishigaki Kazuaki Tsuchiya Hiroshi Takahashi |
| author_facet | Taihei Go Toshiyuki Tsutsui Yasuaki Iida Katsunori Fukutake Ryoichi Fukano Kosei Ishigaki Kazuaki Tsuchiya Hiroshi Takahashi |
| author_sort | Taihei Go |
| collection | DOAJ |
| description | A 76-year-old woman with a spinal subdural hematoma (SDH) was presented with severe back pain without headache. Magnetic resonance imaging (MRI) performed 4 days after onset showed SDH extending from Th2 to L3. She was diagnosed with spontaneous SDH without neurological manifestation, and conservative treatment was selected. Transient disturbance of orientation appeared 7 days after onset. Small subarachnoid hemorrhage (SAH) was detected on head CT, and strict antihypertensive therapy was started. Symptoms changed for the better. Back pain disappeared 4 weeks after onset. On follow-up MRI at 6 months after onset, the SDH had been resolved spontaneously. Although adhesive arachnoiditis was observed at Th4-6, the recurrence of clinical symptoms was not observed at one year and a half after onset. Spinal subdural space is almost avascular; a hematoma in a subdural space is considered to come from a subarachnoid space when it is a lot. A hemorrhage in subarachnoid space was flushed by cerebral spinal fluid; hematoma or arachnoiditis was not formed in general. In our case, hemorrhage was a lot and expansion of SDH was large enough to cause cranial SAH and arachnoiditis. But longitudinally expanded SDH did not show neurological manifestation and resolved spontaneously in our case. |
| format | Article |
| id | doaj-art-a8b83e6857ba4e30a82a326c4f4207fa |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-a8b83e6857ba4e30a82a326c4f4207fa2025-02-03T05:52:41ZengWileyCase Reports in Orthopedics2090-67492090-67572019-01-01201910.1155/2019/73847017384701A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive ArachnoiditisTaihei Go0Toshiyuki Tsutsui1Yasuaki Iida2Katsunori Fukutake3Ryoichi Fukano4Kosei Ishigaki5Kazuaki Tsuchiya6Hiroshi Takahashi7Department of Orthopedic Surgery, Sagamihara Chuo Hospital, Kanagawa, JapanDepartment of Orthopedic Surgery, Sagamihara Chuo Hospital, Kanagawa, JapanDepartment of Orthopedic Surgery, Toho University, Tokyo, JapanDepartment of Orthopedic Surgery, Toho University, Tokyo, JapanDepartment of Orthopedic Surgery, Toho University, Tokyo, JapanDepartment of Orthopedic Surgery, Toho University, Tokyo, JapanDepartment of Orthopedic Surgery, Toho University, Tokyo, JapanDepartment of Orthopedic Surgery, Toho University, Tokyo, JapanA 76-year-old woman with a spinal subdural hematoma (SDH) was presented with severe back pain without headache. Magnetic resonance imaging (MRI) performed 4 days after onset showed SDH extending from Th2 to L3. She was diagnosed with spontaneous SDH without neurological manifestation, and conservative treatment was selected. Transient disturbance of orientation appeared 7 days after onset. Small subarachnoid hemorrhage (SAH) was detected on head CT, and strict antihypertensive therapy was started. Symptoms changed for the better. Back pain disappeared 4 weeks after onset. On follow-up MRI at 6 months after onset, the SDH had been resolved spontaneously. Although adhesive arachnoiditis was observed at Th4-6, the recurrence of clinical symptoms was not observed at one year and a half after onset. Spinal subdural space is almost avascular; a hematoma in a subdural space is considered to come from a subarachnoid space when it is a lot. A hemorrhage in subarachnoid space was flushed by cerebral spinal fluid; hematoma or arachnoiditis was not formed in general. In our case, hemorrhage was a lot and expansion of SDH was large enough to cause cranial SAH and arachnoiditis. But longitudinally expanded SDH did not show neurological manifestation and resolved spontaneously in our case.http://dx.doi.org/10.1155/2019/7384701 |
| spellingShingle | Taihei Go Toshiyuki Tsutsui Yasuaki Iida Katsunori Fukutake Ryoichi Fukano Kosei Ishigaki Kazuaki Tsuchiya Hiroshi Takahashi A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis Case Reports in Orthopedics |
| title | A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis |
| title_full | A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis |
| title_fullStr | A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis |
| title_full_unstemmed | A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis |
| title_short | A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis |
| title_sort | case of spontaneous spinal subdural hematoma complicated by cranial subarachnoid hemorrhage and spinal adhesive arachnoiditis |
| url | http://dx.doi.org/10.1155/2019/7384701 |
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