Acute spontaneous spinal subdural
haematomas in a patient with essential
thrombocythaemia

Konitsiotis, Spiros; Glantzouni, A.; Argyropoulou, M. I.; Tsapoga, T.; Elisaf, Moses; Efremidis, Stavros C.

doi:10.1007/s00415-003-0125-1

Cited by 15 publications

(9 citation statements)

References 10 publications

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“…Of these cases, 3 involved patients who had undergone ventricu loperitoneal (VP) shunt placement, 31,37,42 3 cases were postcraniotomy, 26,36,43 17 were posttrauma, 1,4,5,7,8,13,17,20,21,24,29,30,34,35,[39][40][41] and in 12 cases the SDH arose spontaneous ly. [9][10][11]16,18,22,25,28,30,38,44,45 Leakage of intracranial SDH fluid into the spinal subdural space may be involved in patients who manifest spinal SDH after VP shunt placement. Low CSF pressure is a risk factor for spinal SDH 13,15,26,43 in the absence of intracranial SDH extension, and low CSF pressure syndrome elicited by the overflow of CSF in the VP shunt may result in concomitant hemorrhages.…”

Section: Discussionmentioning

confidence: 99%

“…Of 12 previously reported cases of spontaneous SDH, 5 (42%) involved patients with a bleeding tendency; 3 of these patients had blood dyscrasia, and 2 had been treated with drugs that can affect bleeding. 9,11,18,38,44 Interestingly, among the 17 earlier trauma patients, 7 (41%) also had a bleeding tendency, 1 presented with blood dyscrasia, and 6 were on drug therapy that can affect bleeding. 7,17,20,29,30,40,41 The patient in our Case 1 also had a history of myelo dysplastic syndrome and hemorrhagic diathesis.…”

Section: Discussionmentioning

confidence: 99%

“…Of 29 earlier patients with posttraumatic or spon taneous hematomas, 1,3,5,[7][8][9][10][11]13,[16][17][18][20][21][22]24,25,[28][29][30][31][34][35][36][37][38][39][40][41][42][43][44][45] 11 had undergone surgery, 2 aspiration by lumbar puncture, and 16 had been placed under observation. In both of our pa tients with concomitant asymptomatic spinal SDH the lesions resolved spontaneously with conservative man agement.…”

Section: Discussionmentioning

confidence: 99%

“…Also, we included only patients with chronic SDH. Al though none of them presented with acute SDH, other authors 1,8,9,16,18,24,29,38,40,41 have encountered patients with concomitant SDH who did. Because we did not acquire brain MRI scans, we could not compare the intensity of the intracranial and lumbar SDH in our 2 patients who had concomitant lesions.…”

Section: Discussionmentioning

confidence: 99%

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Prospective assessment of concomitant lumbar and chronic subdural hematoma: is migration from the intracranial space involved in their manifestation?

Kokubo

Kim

Mishina

et al. 2014

SPI

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Object Spinal subdural hematomas (SDHs) are rare and some are concomitant with intracranial SDH. Their pathogenesis and etiology remain to be elucidated although their migration from the intracranial space has been suggested. The authors postulated that if migration plays a major role, patients with intracranial SDH may harbor asymptomatic lumbar SDH. The authors performed a prospective study on the incidence of spinal SDH in patients with intracranial SDH to determine whether migration is a key factor in their concomitance. Methods The authors evaluated lumbar MR images obtained in 168 patients (125 males, 43 females, mean age 75.6 years) with intracranial chronic SDH to identify cases of concomitant lumbar SDH. In all cases, the lumbar MRI studies were performed within the 1st week after surgical irrigation of the intracranial SDH. Results Of the 168 patients, 2 (1.2%) harbored a concomitant lumbar SDH; both had a history of trauma to both the head and the hip and/or lumbar area. One was an 83-year-old man with prostate cancer and myelodysplastic syndrome who suffered trauma to his head and lumbar area in a fall from his bed. The other was a 70-year-old man who had hit his head and lumbar area in a fall. Neither patient manifested neurological deficits and their hematomas disappeared under observation. None of the patients with concomitant lumbar SDH had sustained head trauma only, indicating that trauma to the hip or lumbar region is significantly related to the concomitance of SDH (p < 0.05). Conclusions As the incidence of concomitant lumbar and intracranial chronic SDH is rare and both patients in this study had sustained a direct impact to the head and hips, the authors suggest that the major mechanism underlying their concomitant SDH was double trauma. Another possible explanation is hemorrhagic diathesis and low CSF syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prospective assessment of concomitant lumbar and chronic subdural hematoma: is migration from the intracranial space involved in their manifestation?

Kokubo

Kim

Mishina

et al. 2014

SPI

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“…Spinal subdural hematoma (SDH) is a rare and potentially life threatening condition associated with trauma, lumbar puncture [1], hemorrhagic disorder, anticoagulant therapy [2], spinal surgery, tumor, vascular malformations, and spinal or epidural anesthesia [3]. Traumatic spinal SDH is more uncommon with only 10 reported cases in the literature (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Traumatic lumbar spinal subdural hematoma

Gordon

Kimball

Arthur

2014

Interdisciplinary Neurosurgery

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a b s t r a c tSpinal subdural hematoma (SDH) is a rare and potentially life-threatening condition associated with trauma, lumbar puncture, hemorrhagic disorder, anticoagulant therapy, spinal surgery, tumor, vascular malformations, and spinal or epidural anesthesia. Traumatic SDH is even more uncommon than other forms of SDH with only 10 reported cases in the literature. Following a punch to the head and loss of consciousness, a 35-year-old man reported headaches, right-sided tinnitus, and dull ache behind both eyes. He also experienced sacral pain with stiffness that was exacerbated by movement. MRI showed an isolated lumbar SDH causing mild stenosis. On follow-up, the patient still experienced right-sided tinnitus and bilateral sacral radiculopathy and was prescribed prednisone with repeat MRI at 6weeks. At the next follow-up, the patient's radiculopathy had resolved completely. Our case illustrates rapid resolution of a posttraumatic spinal SDH after treatment with oral corticosteroids. Recognition of blood products on MRI is vital to diagnosis and expedient treatment. There is agreement that prompt laminectomy with evacuation of SDH should be performed before permanent damage to the spinal cord occurs. Including our patient, 4 of 11 reported cases of thoracic or lumbar SDH resolved with conservative treatment.

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Syringomyelia following surgery for a spontaneous spinal subdural hematoma in a 13-year-old girl with congenital von Willebrand disease: case report and literature review

2015

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Acute spontaneous spinal subdural haematomas in a patient with essential thrombocythaemia

Cited by 15 publications

References 10 publications

Prospective assessment of concomitant lumbar and chronic subdural hematoma: is migration from the intracranial space involved in their manifestation?

Prospective assessment of concomitant lumbar and chronic subdural hematoma: is migration from the intracranial space involved in their manifestation?

Traumatic lumbar spinal subdural hematoma

Syringomyelia following surgery for a spontaneous spinal subdural hematoma in a 13-year-old girl with congenital von Willebrand disease: case report and literature review

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