Spinal chronic subdural hematoma in a patient with ventriculo-peritoneal shunting after a minor trauma

Abstract

Study design: Case report and review of literature. Objectives: Intracranial chronic subdural hematoma (SDH) is a well-recognized complication of ventriculoperitoneal (VP) shunt. Spinal chronic SDH is very rarely associated with VP shunt. Setting: Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Case report: We describe a spinal chronic SDH, developing after a minor trauma, in a patient who underwent a VP shunt surgery for hydrocephalus 6 months previously. A good outcome was achieved after decompressive surgery. Conclusion: Spinal chronic SDH should be considered in the diagnosis of progressive spinal compression, especially in the patients with VP shunt after minor trauma.

Idiopathic Lumbosacral Spinal Chronic Subdural Hematoma

“…Early surgical decompression results in a good outcome. The literature showed 80% improvement in neurological function after surgery 1 , 3 , 10 , 13) .…”

“…Various hypotheses of spinal SDH have been proposed, increased intravascular pressure in subdural space due to increased intrathoracic or intraabdominal pressure resulting from trauma, cause a failure in the spinal cord vascular. Another hypothesis is migration of hematoma from intracranial subarachnoid to the spine due to gravity 8 , 13) .…”

“…The treatment of choice is laminectomy and drainage of hematoma 4 , 9 , 13) . Despite of spontaneous remission of intraspinal hematoma has been reported, early surgical decompression is commonly required, because of progression of neurological deterioration caused by spinal cord compression, ischemia, and direct injury to spinal cord.…”

Posttraumatic Acute Spinal Subdural Hematoma of the Spine

“…16,23 Symptomatic ASSH is a neurosurgical emergency that needs an urgent evacuation of the blood clot and decompression of the neural structures to avoid irreversible deficits. 8,15,[23][24][25][26][27] However, in selected cases with smaller size of the clot and no mass effect, a conservative management has shown favorable outcome. 15,28 Conclusion ASSH is an uncommon complication of the spinal injury.…”