Open AccessA delayed-onset intracranial chronic subdural hematoma following a lumbar spinal subdural hematoma
Author(s) -
Takaaki Uto,
Noritaka Yonezawa,
Nobuhiko Komine,
Yuji Tokuumi,
Keiichiro Torigoe,
Yukihiko Koda,
Hiroyuki Tsuchiya
Publication year - 2018
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000012479
Subject(s) - medicine , lumbar , hematoma , surgery , magnetic resonance imaging , lumbar puncture , anesthesia , radiology , cerebrospinal fluid , pathology
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.