A delayed-onset intracranial chronic subdural hematoma following a lumbar spinal subdural hematoma

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.

Spinal Subdural Hematoma Migration From a Cranial Subdural Hematoma: Two Case Reports and Literature Review

“…To the best of our knowledge, 43 cases of simultaneous CSDH and SSDH cases have been reported. Of these cases, 22 were post-trauma, three were post-craniotomy, three were after ventriculoperitoneal shunt placement, and the remaining 15 were spontaneous cases [ 1 - 7 ].…”

“…Previous reports have suggested etiologies involving hematoma migration from the cranial to the spinal sites or a coincidence of both CSDH and SSDH [ 1 , 2 ]. To our knowledge, 43 cases of simultaneous CSDH and SSDH occurrence have been reported [ 1 - 7 ]. Of these, only 15 cases were considered to have had both CSDH and SSDH without specific triggers [ 3 - 5 ].…”

Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature review

“…We also reviewed the literature on patients with SDH with secondary ICPR (Table 1). Although the risk of neurological complications following spinal anesthesia was evaluated to be only 1/20,000 to 1/30,000 (46), and to be only 0.8% following spinal surgery (47); in the reported cases, the leading causes of rupture of the dura mater before SDH were intravertebral anesthesia (2, 23-25, 32, 40, 43-45), and lumbar surgery (26-31, 34, 35, 37, 41, 42). Other causes of dura rupture include myelography and epidural steroid injection (36,39,41).…”