Spinal subarachnoid hematoma of unknown etiology: A case report

Abstract

A case of spinal subarachnoid hematoma at T3-T7 level is reported in a 60-year-old hunter, who developed progressive spinal cord impairment after receiving the recoil of his shotgun. Both clinical and neuroradiological investigations, including the selective spinal angiography, failed to demonstrate the origin of the bleeding. The combination of an apparently trivial spinal trauma with temporary increase of the intrathoracic pressure might be considered as possible etiologic factor.

Spontaneous spinal subarachnoid hemorrhage after severe coughing: a case report

“…Consciousness disturbance was observed in three of the 20 cases [3,10]. The circumstances at the time of onset of symptoms include eating, bending the head, scuba diving, having sexual intercourse, defecating, receiving the recoil of a shotgun, and jumping into the sea [1-3,5,10,12,13,15]. To the best of our knowledge, there have been no reported cases of SSH that developed after severe coughing.…”

“…Acute spontaneous SSH is a potentially dangerous condition and may have disastrous consequences; thus, urgent decompressive surgery should be performed when the neurological state progressively deteriorates, unlike in our patient [3,4,10-13]. When bleeding occurs in the subarachnoid space, the CSF may dilute the subarachnoid hemorrhage, and defibrination by pulsation of the spinal cord reduces the likelihood of subarachnoid hematoma formation [1,2].…”

Spontaneous spinal subarachnoid haemorrhage—a complication of alcohol withdrawal therapy

“…Spinal subarachnoid haemorrhage has been reported to be caused by tumours, arteriovenous malformations (AVM), trauma, coagulopathy or iatrogenic procedures including surgery, spinal anaesthaesia or myelography [3][4][5][6][7][8][9][10]. Other conditions reported to be associated with SSH are acute leukaemia [11], collagen vascular disorders such as systemic lupus erythematosus [12] and Behçet's disease [13]. Some authors discuss spondylo-arthritic processes [14,15], arachnoiditis [16], disc herniation [17] or hypertrophy of the yellow ligaments [18] as possible causes.…”

Spinal Subarachnoid Hematoma After Spinal Anesthesia

“…Th e term spinal subarachnoid hematoma was introduced in 1967 by Berney et al 11 to defi ne a rare condition, in which hemorrhage in the subarachnoid space with an intact arachnoid membrane forms a clot/blood collection, and due to the mass eff ect, generates a medullary or cauda equina compression DISCUSSION syndrome. Only after 1984, the terms spinal subarachnoid hemorrhage and spinal subarachnoid hematoma were used separately in the literature to distinguish between these two different modalities of bleeding in subarachnoid space [11][12][13] .…”

“…However, in some situations such as spondylarthrosis 13,16 , arachnoiditis 17 , disc herniation 18 , and yellow ligament hypertrophy 19 , normal CSF flow is compromised and the spinal canal is narrower, with a greater predisposition to form hematomas. On the other hand, even when there are no anatomical changes in the vertebral canal, the hematoma can occur if substantial bleeding is present.…”