A delayed-onset intracranial chronic subdural hematoma following a lumbar spinal subdural hematoma: A case report. Issue 38 (September 2018)

• Record Type: Journal Article
• Authors: Uto, Takaaki; Yonezawa, Noritaka; Komine, Nobuhiko; Tokuumi, Yuji; Torigoe, Keiichiro; Koda, Yukihiko; Tsuchiya, Hiroyuki
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 97:Issue 38(2018)
• Publication Date: 2018-09
• Subjects: antiplatelet therapy -- computed tomography -- intracranial chronic subdural hematoma -- lumbar spinal subdural hematoma -- magnetic resonance imaging; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000012479
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: 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.