Delayed Development of Spinal Subdural Hematoma Following Cranial Trauma: A Case Report and Review of the Literature

Hsieh, Jason K.; Colby, Samantha; Nichols, Daniel H.; Kondylis, Efstathios; Liu, James K.

doi:10.1016/j.wneu.2020.05.158

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…That study reported that 50% of patients who underwent surgical decompression either fully recovered or were independent with respect to activities of daily living at the last follow-up [2]. Although an earlier report recommended decompression for SSDHs that are symptomatic or associated with neurological deficits [15], a recent literature review by Hsieh et al [16] that reported 18 cases of traumatic SSDH suggests that conservative management may also be a reasonable treatment option for these patients. In that review, eight patients with isolated spinal trauma had associated SSDHs that were treated conservatively; of these patients, seven had improvement or complete resolution of their symptoms, including patients with profound motor and sensory deficits [16].…”

Section: Discussionmentioning

confidence: 99%

“…Although an earlier report recommended decompression for SSDHs that are symptomatic or associated with neurological deficits [15], a recent literature review by Hsieh et al [16] that reported 18 cases of traumatic SSDH suggests that conservative management may also be a reasonable treatment option for these patients. In that review, eight patients with isolated spinal trauma had associated SSDHs that were treated conservatively; of these patients, seven had improvement or complete resolution of their symptoms, including patients with profound motor and sensory deficits [16]. However, given the limited number of patients in that review, selection bias may have played an important role in the results.…”

Section: Discussionmentioning

confidence: 99%

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Spinal Subdural Hematoma in Ankylosing Spondylitis Patients Without Anticoagulation Therapy

Berglar,

Williams,

Catapano

et al. 2023

Cureus

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Patients with ankylosing spondylitis are at high risk of significant spinal trauma after relatively low-impact events, such as ground-level falls. Because of the osteopenic nature of the disease process, complex spinal fractures are common in these patients. Additionally, patients may sustain rare traumatic complications from these fractures, such as a spinal subdural hematoma (SSDH) or epidural hematoma. Traumatic SSDH is extremely rare, with few cases described in the literature, and cases are typically associated with antiplatelet or anticoagulant use. This study reviews the literature related to traumatic SSDH in patients with ankylosing spondylitis and describes two cases of traumatic SSDH in patients with ankylosing spondylitis without anticoagulation or antiplatelet therapy, which has not previously been reported in the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spinal Subdural Hematoma in Ankylosing Spondylitis Patients Without Anticoagulation Therapy

Berglar,

Williams,

Catapano

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…In comparison, spinal SDH is rare, making up only 4% of cases of spinal hematoma [ 2 ]. Even more rarely, an intracranial SDH may migrate downward, causing an additional lumbar SDH [ 3 , 4 ], which may lead to a confusing clinical picture with low back and radicular pain without cranial symptoms [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Concurrent Spinal and Intracranial Subdural Hematomas as a Cause of Near-Fatal Low Back Pain in the Chiropractic Office: A Case Report

Chu¹,

Trager²,

Nga³

et al. 2022

Cureus

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In older individuals, minor trauma may cause potentially fatal intracranial subdural hematoma (SDH). Rarely, these patients present with only low back and radicular pain as gravity redistributes the SDH to the lumbar spine.A 69-year-old male presented to a chiropractor with a 10-day history of acute on chronic low back pain, which radiated into his lower extremities bilaterally, involving weakness and difficulty walking, and a ground-level fall onto his elbows 16 days prior. He had visited his primary care provider, orthopedist, and traditional Chinese medicine practitioner, received oral analgesics and three ketorolac injections, and had lumbar radiographs, followed by acupuncture, cupping, and spinal manipulation without lasting relief. Considering the patient's concerning presentation, the chiropractor ordered lumbar magnetic resonance imaging (MRI) on the first visit, revealing findings suggestive of late subacute lumbar SDH, and recommended urgent brain MRI and neurosurgical referral. The patient went to an orthopedic surgeon at a nearby hospital, becoming disoriented upon presentation, prompting admission. Brain MRI confirmed bilateral chronic intracranial SDH, prompting emergency hematoma evacuation via burr hole craniostomy. The patient's gait rapidly improved, and the pain subsided over the following two weeks. This case highlights an older male identified as having spinal SDH by a chiropractor, leading to referral and surgery for concurrent life-threatening intracranial SDH. Clinicians should be aware that spinal SDH may stem from asymptomatic intracranial SDH and should be suspicious of SDH in older individuals after a fall, signs of which warrant emergency referral for MRI and surgical evaluation.

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Review of Craniospinal Acute, Subacute, and Chronic Subdural Hematomas

Akhaddar

2021

Subdural Hematoma

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Delayed Development of Spinal Subdural Hematoma Following Cranial Trauma: A Case Report and Review of the Literature

Cited by 6 publications

References 27 publications

Spinal Subdural Hematoma in Ankylosing Spondylitis Patients Without Anticoagulation Therapy

Spinal Subdural Hematoma in Ankylosing Spondylitis Patients Without Anticoagulation Therapy

Concurrent Spinal and Intracranial Subdural Hematomas as a Cause of Near-Fatal Low Back Pain in the Chiropractic Office: A Case Report

Review of Craniospinal Acute, Subacute, and Chronic Subdural Hematomas

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