Spontaneous Intracranial and Lumbar Subdural Hematoma Presenting as Vaginal Pain

Weiner, Lindsay A.; Richardson, Adam C.; Tewelde, Semhar Z.

doi:10.1016/j.jemermed.2018.12.032

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…The patient’s back pain on admission is consistent with the presentation of a spinal hematoma as described by Michon in 1928 as “le coup de poignard”, or knife stabbing the spine [ 7 ]. Although typically presenting as radicular back pain associated with symptoms of myelopathy such as paresthesia, progressive paresis, bowel or bladder dysfunction, SSDH can at times present with vague or unusual symptoms like vaginal or perineal pain, and pure hemiparesis [ 8 - 11 ]. However, de Beer et al and Domenicucci et al both found that motor deficit was the most common presentation for SSDH [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Spinal Subdural Hematoma Mimicking Myocardial Infarction

Ghanchi

Siddiqi

Takayanagi

et al. 2020

Cureus

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Spontaneous spinal subdural hematomas (SSDHs) are rarely encountered in clinical practice. In this paper, we report a case of a 70-year-old female who presented to the Emergency Department with symptoms of mid-epigastric pain radiating to her mid-scapular region. Her workup demonstrated mildly elevated cardiac troponin I levels and electrocardiogram (ECG) leads V3-V5 ST-depressions. She was subsequently treated through the non-ST elevation myocardial infarction (NSTEMI) protocol and given an antiplatelet agent. The next morning, she developed bilateral lower extremity paresthesias, progressive left lower extremity weakness, and urinary retention. Magnetic resonance imaging (MRI) of the spine demonstrated a hematoma in the thoracic region resulting in spinal cord compression. The patient underwent surgical decompression. After the decompression of the thoracic spinal cord, the patient's neurological symptoms gradually improved and she regained lower extremity function. This report brings to light a very unusual presentation of an uncommon clinical entity. To the best knowledge of the authors, spontaneous SSDH presenting as myocardial injury and subsequently exacerbated by anticoagulation therapy has not been reported in the literature to date.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Spinal Subdural Hematoma Mimicking Myocardial Infarction

Ghanchi

Siddiqi

Takayanagi

et al. 2020

Cureus

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Aspirin/warfarin

2019

Reactions Weekly

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Massive Acute Spinal Subdural Hematoma Causing Sudden Onset Paraplegia in a Patient on Anticoagulation

Kosarchuk

Lewis

Pham

2020

Case Reports in Surgery

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Spinal subdural hematoma (SSDH) is a rare but known entity that can cause severe and irreversible motor, sensory, and autonomic dysfunction if not decompressed in a timely manner. We present here a 74-year-old female on anticoagulation who developed sudden onset back pain with rapidly progressive paraplegia. On neurologic exam, she was completely flaccid in the bilateral lower extremities with absent sensation from the umbilicus down. Imaging demonstrated a massive extra-axial spinal hematoma from T12 to S1 that initially was believed to be epidural in origin. She was taken emergently to the operating room for a T11-L5 decompressive laminectomy, and dural opening demonstrated a thick subdural clot encasing the conus and cauda equina confirming the subdural pathology. Despite decompression and partial evacuation of the subdural hematoma, she did not recover neurologic function.

show abstract

Spontaneous Intracranial and Lumbar Subdural Hematoma Presenting as Vaginal Pain

Cited by 4 publications

References 19 publications

Spontaneous Spinal Subdural Hematoma Mimicking Myocardial Infarction

Spontaneous Spinal Subdural Hematoma Mimicking Myocardial Infarction

Aspirin/warfarin

Massive Acute Spinal Subdural Hematoma Causing Sudden Onset Paraplegia in a Patient on Anticoagulation

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