Acute, Nontraumatic Spontaneous Spinal Subdural Hematoma: A Case Report and Systematic Evaluate of the Literature.
Case Rep Neurol Med. 2017;2017:2431041
Authors: Rettenmaier LA, Holland MT, Abel TJ
Spontaneous spinal subdural hematoma (sSDH) is a uncommon situation outright. Furthermore, instances that happen spontaneously within the absence of an identifiable etiology are significantly much less frequent and stay poorly understood. Right here, we current the case of a 43-year-old man with spontaneous sSDH presenting with acute onset low again ache and paraplegia. Pressing magnetic resonance imaging recognized a dorsal SDH from T8 to T11 with compression of the spinal twine. Emergent T8-T10 laminectomies with intradural exploration and hematoma evacuation had been carried out. Nonetheless, regardless of immediate identification and applicable motion, the affected person’s restoration was modest and important incapacity remained at discharge. This distinctive and strange case demonstrates that spontaneous sSDH requires immediate surgical remedy to reduce related morbidity and helps the affiliation between the presence of extreme neurological deficits upon preliminary presentation with much less favorable outcomes. We carried out a complete systematic evaluation of spontaneous sSDH of unknown etiology, which demonstrates that emergent surgical intervention is indicated for sufferers presenting with extreme neurological deficits and the presence of those deficits is predictive of poor neurological final result. Moreover, conservative administration needs to be thought of in sufferers presenting with gentle neurological deficits as spontaneous decision adopted by favorable neurological outcomes is commonly noticed in these sufferers.
PMID: 29441210 [PubMed]