Medicine · 2018
A delayed-onset intracranial chronic subdural hematoma following a lumbar spinal subdural hematoma: A case report.
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Uto Takaaki, Yonezawa Noritaka, Komine Nobuhiko, Tokuumi Yuji, Torigoe Keiichiro, Koda Yukihiko, Tsuchiya Hiroyuki
Аннотация
RATIONALE: A spinal subdural hematoma (SDH) is rarely complicated with an intracranial SDH. We found only 7 cases of spontaneous concurrent lumbar spinal and cranial SDHs, in which lumbar symptoms occurred before head symptoms.
PATIENT CONCERNS: We describe a 77-year-old man with spontaneous concurrent spinal and cranial SDHs, in whom the spinal SDH was identified 30 days before the intracranial chronic SDH.
DIAGNOSIS: Magnetic resonance imaging showed a spinal SDH at L4/L5. There was no paralysis, and the patient was managed conservatively. About 30 days after the onset of back pain, he experienced tinnitus and visual hallucination. Brain computed tomography showed a chronic SDH and midline shift.
INTERVENTIONS: Burr-hole evacuation was performed, and the patient's condition improved.
OUTCOMES: At 5 months of follow-up, there was no recurrence of the spinal or intracranial SDH.
LESSONS: It is important to consider the possibility of intracranial hemorrhage when a spinal SDH is identified.
PATIENT CONCERNS: We describe a 77-year-old man with spontaneous concurrent spinal and cranial SDHs, in whom the spinal SDH was identified 30 days before the intracranial chronic SDH.
DIAGNOSIS: Magnetic resonance imaging showed a spinal SDH at L4/L5. There was no paralysis, and the patient was managed conservatively. About 30 days after the onset of back pain, he experienced tinnitus and visual hallucination. Brain computed tomography showed a chronic SDH and midline shift.
INTERVENTIONS: Burr-hole evacuation was performed, and the patient's condition improved.
OUTCOMES: At 5 months of follow-up, there was no recurrence of the spinal or intracranial SDH.
LESSONS: It is important to consider the possibility of intracranial hemorrhage when a spinal SDH is identified.