Intracranial Vasospasm without Intracranial Hemorrhage due to Acute Spontaneous Spinal Subdural Hematoma

Oh, Jung-Hwan; Jwa, Seung-Joo; Yang, Tae Ki; Lee, Chang Sub; Oh, Kyungmi; Kang, Jihoon

doi:10.5607/en.2015.24.4.366

Cited by 11 publications

(11 citation statements)

References 15 publications

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“…Acute SSDH is a rare condition with unpredictable clinical presentation. Rapidly progressive symptoms due to spinal cord pressure such as sudden onset headache and back pain, sensory-motor change, and autonomous and cardiac dysfunction may develop 6 . Our patient had motor and sensory loss in both lower extremities accompanied by sudden confusion.…”

Section: Discussionmentioning

confidence: 99%

“…The subarachnoid space has a dense plexus of capillaries, and rupture of these radiculomedullary vessels as a result of minor trauma caused by increased intra-abdominal and intra-thoracic pressure associated with events such as cough or yawning has been previously accused. Because of the continuation of cerebrospinal fluid (CSF) flow during the early phase of bleeding and dilution of clotting formation by CSF, thrombosis may not be sufficient leading to SDH 6,8,9 . Therefor in SSDH, the duration of initial clinical symptoms may range from several hours to as long as several months 10 .…”

Section: Discussionmentioning

confidence: 99%

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Non-traumatic Spontaneous Spinal Subdural Hematoma in a Patient with Acute Paraplegia

SAĞLIK

Şencan

Giray

et al. 2022

Journal of Emergency Medicine Case Reports

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Acute non-traumatic spinal subdural hematoma (SSDH) is a rare clinical condition in the emergency medicine practice and difficult to diagnose during the primary physical examination. It mostly occurs at thoracal vertebra levels due to trauma, use of anticoagulants, medical procedures such as acupuncture, arteriovenous malformations, hematological disorders or space-occupying lesions. Here, we discussed an elderly female patient who was not on anticoagulant and described sudden loss of muscle strength and sensation in both lower extremities. Initial laboratory and imaging including brain computerized tomography (CT) and magnetic resonance imaging (MRI) were in normal range. Her secondary examination revealed anesthesia under the T4 dermatome level. Cervical spine-MRI imaging revealed a subdural hematoma significantly compressing the spinal cord on the C7-T1 dermatome segments. Any emergency neurosurgical intervention was not considered and the patient was interned in the neurosurgical clinic for conservative treatment and further examination. Patient , with no progress seen in consecutive MRI scans, was discharged after offering an outpatient check-up. We recommend secondary physical examination in emergency department (ED). In the case of appearance of sensory deficits of certain dermatomes, spine-MR imaging may lead to put the diagnose early in ED.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Non-traumatic Spontaneous Spinal Subdural Hematoma in a Patient with Acute Paraplegia

SAĞLIK

Şencan

Giray

et al. 2022

Journal of Emergency Medicine Case Reports

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“…[13] ere have only been four other cases reported of spinal hematoma resulting in intracranial vasospasm as listed in [Table 1]. [8,9,12,13] ree of these reports found hematoma at level of the spinal cord itself while one reported hematoma around the conus and cauda equina. In all but one case, [9] spinal hematoma associated intracranial vasospasm was also found to have intracranial hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Report of cerebral vasospasm as a complication of intracranial subarachnoid hemorrhage following traumatic lumbar puncture

Arshad

Reier

Fowler

et al. 2022

Surgical Neurology International

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Background: This case report is the first documented and illustrated case of the identification and treatment of intracranial vasospasm as a sequalae of traumatic lumbar puncture (LP). LP is a routine procedure performed for both diagnostic and therapeutic purposes. Although rare, this procedure has risks and complications that should be considered before performing. Case Description: A 58-year-old male was found to have intracranial subarachnoid hemorrhage (SAH) 2 days after a traumatic LP which occurred in the setting of subtherapeutic international normalized ratio. During his hospitalization, the patient developed both clinical and radiographic signs of vasospasm. He was taken for angiography, which demonstrated significant vasospasm of bilateral middle cerebral arteries and bilateral anterior cerebral arteries. All vasospasms resolved and the patient improved clinically after intra-arterial spasmolytic therapy. Conclusion: LP is a routine procedure with complications that are often overlooked. The authors describe intracranial vasospasm from traumatic LP before correction of patient’s coagulopathy. Cases with similar hemorrhage occurring in the spine resulting in non-aneurysmal SAH and vasospasm were reviewed.

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“…Spontaneous spinal subdural hematoma (SSDH) is characterized by the sudden onset of back pain or headache and can lead to severe consequences ( 1 ). The most common causative factors are anticoagulant therapy and dysfunction of blood coagulation, followed by atrogenic procedures using a needle.…”

Section: Introductionmentioning

confidence: 99%

Acute spontaneous spinal subdural hematoma presenting with Takotsubo cardiomyopathy: a rare case report and literature review

et al. 2022

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Spontaneous spinal subdural hematoma (SSDH) is a rare and dangerous intraspinal hematoma that usually occurs in the thoracic vertebra. The influence of early cardiovascular changes secondary to spinal cord injury is an important emergent issue. Herein, we report a case of a middle-aged woman with clinical manifestations of back pain and motion and sensory disturbances below the level of spinal cord compression. During the disease course, she also developed changes indicative of myocardial injury, such as tachycardia, markedly increased concentrations of brain natriuretic peptide and cardiac troponin I, and a decreased left ventricular ejection fraction, which were consistent with the diagnosis of Takotsubo cardiomyopathy (TTC). After the administration of supportive therapies, the symptoms of myocardial injury rapidly resolved. With the absorption of SSDH, the symptoms and clinical signs were alleviated. We also reviewed the literature on cases of concomitant SSDH and TTC. This rare case broadens the symptom spectrum of SSDH and highlights the need for clinicians to be aware of concomitant SSDH and TTC. Initial conservative treatment is a viable option for SSDH with concomitant TTC. However, urgent surgery may be a better option if the SSDH progressively enlarges and causes spinal cord compression.

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Intracranial Vasospasm without Intracranial Hemorrhage due to Acute Spontaneous Spinal Subdural Hematoma

Cited by 11 publications

References 15 publications

Non-traumatic Spontaneous Spinal Subdural Hematoma in a Patient with Acute Paraplegia

Non-traumatic Spontaneous Spinal Subdural Hematoma in a Patient with Acute Paraplegia

Report of cerebral vasospasm as a complication of intracranial subarachnoid hemorrhage following traumatic lumbar puncture

Acute spontaneous spinal subdural hematoma presenting with Takotsubo cardiomyopathy: a rare case report and literature review

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