Introduction: Coexistence of cranial and spinal subdural hematomas is rare and the pathogenesis of simultaneous intracranial and spinal subdural hematoma yet remains unclear. Herein, the authors conducted a systemic review of case reports in the literatures.

Methods: The electronic databases searched to identify potential reports for inclusion based on title and abstract information were perforemed at Feburary, 2013. Each articles was then obtained in complete or abstracted form and further publications in the references of each text were obtained and analyzed. Total 123 cases of distant hemorrhages between cranial and spinal regions were reported in the literature. Among them, 36 cases of distant hemorrhages originated form cranial region were reviewed.

Results: Among 123 cases of distant hemorrhages between cranial and spinal regions in the literature, 36 cases of distant hemorrhages originated from cranial region were observed. The sex, age, anti-coagulant medication, location of cranial hemorrhage were not associated with the development of distant hemorrhages. The possible pathogenesis of distant hemorrhages originated form cranial region was progressive migration of subdural blood to the most dependent areas of the lumbosacral region under the influence of gravity with strong evidence of case reports. The most clinical result was good, but unexpected courses were also observed. The recommend treatment was conservative, but the surgical decompression was also recommended, if it needed.

Conclusions: Coexistence of cranial and spinal subdural hematomas is rare, but could be happen with the migration of subdural blood to the lumbosacral region under the influence of gravity.

Patient Care: Coexistence of cranial and spinal subdural hematomas is rare, but the clinical careful attention is needed to the clinician.

Learning Objectives: Migration of subdural blood to the lumbosacral region under the influence of gravity is key pathogenesis of coexistence of cranial and spinal subdural hematomas originated from cranial region.

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