Idiopathic cervical spinal subdural haematoma: a case report and literature review

Acute idiopathic spinal subdural hematoma: a case report

Acute idiopathic (spontaneous) spinal subdural hematoma (spinal subdural hematomas is a rare neurosurgical emergency, often linked to coagulation disorders, trauma, iatrogenic, and underlying neoplasm, with symptoms worsening gradually. A healthy 34-year-old woman developed sudden paraplegia after back pain. Urgent T1-T2 laminectomy revealed a subdural hematoma, leading to successful evacuation. Eight months postoperative, she walks independently with reduced spasticity and intact muscle strength. The initial presentation may be subtle and symptoms worsen rapidly. Magnetic resonance imaging is the best diagnostic tool, and early decompressive laminectomy is crucial if needed.

Spinal subdural haemorrhage secondary to strenuous exercise and warfarin, complicated by acute ischaemic stroke

Spinal subdural haemorrhage or haematoma (SSDH) is a rare condition that is often overlooked and missed on initial presentation due to its non-specific features that may mimic other more common pathologies. It is associated with high morbidity and mortality rates, with few evidence-based management principles, particularly during the subacute stages of recovery. In this report, we detail a case of SSDH associated with exercise and anticoagulation therapy, which was complicated by acute ischaemic stroke. SSDH should be suspected in cases of acute back pain without a clear alternative cause, particularly in coagulopathic individuals. Following treatment, early recommencement of anticoagulation therapy may be justified in certain cases where indicated, after careful consideration of the affected individual's risk profile.

Spontaneous spinal subdural hematoma in COVID-19 patient: Croatian national COVID hospital experience

Background:

Spontaneous spinal subdural hematoma (SSDH) is a rare condition and causes of acute spinal cord compression, with symptoms varying from mild to severe neurological deficit. SSDH could occur as a consequence of posttraumatic, iatrogenic, or spontaneous causes, including underlying arteriovenous malformations, tumors, or coagulation disorder. Due to its rarity, it is difficult to establish standardized treatment. We present a rare case of SSDH in COVID-19 patient and course of treatment in COVID hospital.

Case Description:

A 71-year-old female patient was admitted due to instability, weakness of the left leg, and intensive pain in the upper part of thoracic spine as well as mild respiratory symptoms of COVID-19. She was not on pronounced anticoagulant therapy and her coagulogram at admission was within normal range. MRI revealed acute subdural hematoma at the level C VII to Th III compressing the spinal cord. The patient underwent a decompressive Th I and Th II laminectomy and hematoma evacuation. Post-operative MRI revealed a satisfactory decompression and re-expansion of the spinal cord. COVID-19 symptoms remained mild.

Conclusion:

SSDH represents a neurological emergency, possibly leading to significant deficit and requires urgent recognition and treatment. One of the main difficulties when diagnosing is to consider such condition when there is no history of anticoagulant treatment or previous trauma. Since high incidence of coagulation abnormalities and thromboembolic events was described COVID-19 patients, when considering the pathology of the central nervous system, the bleeding within it due to COVID-19 should be taken into account, in both brain and spine.

Acute Spontaneous Spinal Subdural Hematoma: A Case Report

Patient: Male, 25-year-old

Final Diagnosis: Acute spontaneous spinal subdural hematoma

Symptoms: Weakness

Medication:—

Clinical Procedure: —

Specialty: Critical Care Medicine • Neurology • Neurosurgery • Radiology