“…With regard to anatomy, there is a relative lack of vessels within the subdural space of the spinal canal ( 32 ), unlike the bridging veins of the cranial compartment. The other proposed hypotheses include sudden increases in intraabdominal pressure resulting in rupture of a spinal hemorrhage vessel with spinal subdural hemorrhage ( 33,34 ), hyperfl exion of the spine causing injury to the vessels traveling within the spinal nerve sheath along the spinal nerves as well as the ventral and dorsal nerve roots that result in bleeding into the subdural space ( 12 ), and increased intracranial pressure indirectly increasing the shearing force between spinal subdural and subarachnoid spaces that results in tear and bleeding of the inner dural layer of the spine ( 17,35 ). Some of these hypotheses are not well accepted facts and lack any evidence.…”
Section: Pediatric Imaging: Spinal Subdural Hemorrhage In Head Traumamentioning
Spinal canal subdural hemorrhage was present in more than 60% of children with abusive head trauma who underwent thoracolumbar imaging in this series but was rare in those with accidental trauma.
“…With regard to anatomy, there is a relative lack of vessels within the subdural space of the spinal canal ( 32 ), unlike the bridging veins of the cranial compartment. The other proposed hypotheses include sudden increases in intraabdominal pressure resulting in rupture of a spinal hemorrhage vessel with spinal subdural hemorrhage ( 33,34 ), hyperfl exion of the spine causing injury to the vessels traveling within the spinal nerve sheath along the spinal nerves as well as the ventral and dorsal nerve roots that result in bleeding into the subdural space ( 12 ), and increased intracranial pressure indirectly increasing the shearing force between spinal subdural and subarachnoid spaces that results in tear and bleeding of the inner dural layer of the spine ( 17,35 ). Some of these hypotheses are not well accepted facts and lack any evidence.…”
Section: Pediatric Imaging: Spinal Subdural Hemorrhage In Head Traumamentioning
Spinal canal subdural hemorrhage was present in more than 60% of children with abusive head trauma who underwent thoracolumbar imaging in this series but was rare in those with accidental trauma.
“…3,4,6,8,17) The lumbar 4,8) and thoracolumbar 3,6) regions were the most common sites for the spontaneous SCSDH. Only one case was a cervical SCSDH.…”
Section: Discussionmentioning
confidence: 99%
“…2,12,14,19) Only five cases of spontaneous SCSDH without specific pathology have been reported. 3,4,6,8,17) We report another case of spontaneous SCSDH in a child with no associated trauma or medical problems that resolved spontaneously.…”
A 13-year-old boy presented with a rare spontaneous spinal chronic subdural hematoma (SCSDH) with no associated trauma or medical problems manifesting as back and bilateral lower extremity pain persisting for 10 days. Neurological examination revealed mild weakness and paresthesia in both lower extremities. Magnetic resonance (MR) imaging performed 1 week after the appearance of symptoms revealed a chronic subdural hematoma at the thoracolumbosacral region. Follow-up MR imaging performed 1 week later showed significant resolution of the hematoma without the need for surgery. The patient was discharged with only conservative management. This case of spontaneous SCSDH with rapid spontaneous remission in a child not associated with coagulopathy indicates that aggressive surgical treatment should be delayed as long as possible in pediatric patients because the spinal structure is still developing.
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