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  • Traumatic Bilateral Intracranial Subdural Hematoma with a Spinal Component in an Elderly Patient

    Final Number:
    4186

    Authors:
    Rajeet Singh Saluja MD; Judith Marcoux; Mohammed Abdullah S Mansi; Rakan Bokari MBBS, MSc.; Monica Hampe BSc

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting - Late Breaking Science

    Introduction: Bilateral Intracranial subdural Hematoma (SDH) associated with an extension to the spine are fairly uncommon. The acute progression of spinal hemorrhage can lead to devastating neurologic sequelae. Other symptoms may include headaches, dizziness, back and neck pain. Other causes of this entity were ruled out by history, physical examination and neuroimaging.

    Methods: The condition can be spontaneous or caused by bleeding dyscrasias, anticoagulants, trauma, iatrogenic procedures, and vascular malformations. The authors in this case describe a 77 year old female with a past medical illness of atrial fibrillation, hypertension, dyslipemia, osteoporosis and vascular cerebral accident. The patient was transferred from another hospital as an elective admission with an alert level of consciousness and a history of fall. The clinical and imaging data of this patient confirmed the diagnosis. Patient underwent bilateral burr hole and craniotomy for evacuation of the SDH, C4-C6 laminectomy and T12-L1 Laminectomy were performed for decompression and a subdural lumber drain was placed. patient condition rapidly deteriorated in the Intensive care unit. Multiple underlying conditions has led to her demise.

    Results: The Mechanism of the disease is still unclear. One theory suggests that the pressure from cranial space may increase shearing force between spinal subdural and subarachnoid spaces, so the inner dura may tear and bleed in the arahnoidal space. Unlike the intracranial subdural space, the spinal subdural space is an avascular space, thereby assuming that hemorrhage in subdural space might come from a subarachnoid source. The finding of accompanying subarachnoid hemorrhage was found in several cases. Surgery was indicated in this case because the patient condition was shifted from moderate to severe with extensive hematoma to the spinal cord in lumbosacral region with positive neurological deficit.

    Conclusions: We report a case of traumatic bilateral SDH which is rarely associated with Spinal SDH, a potentially life-threatening condition.

    Patient Care: Prompt diagnosis and and course of treatment including emergency surgery can lead to the better outcomes in these cases from rapid decline in status.

    Learning Objectives: our approach and regimen to treating patients with bilateral subdural hematoma with spinal complications. Prompt surgery in a timely matter can help save those patient from d

    References: (1)KJ Jibu, MB Pranesh, B Prakash, and K Saifudheen.Bilateral intracranial and spinal subdural hematoma presenting as bilateral sciatica.J Neurosci Rural Pract. 3(1): 97–98, 2012. (2)Myoung Soo Kim, M.D., Ph.D.corresponding author* and Sook Young Sim, M.D., Ph.D.Spinal Subdural Hematoma Associated with Intracranial Subdural Hematoma.J Korean Neurosurg Soc. 58(4): 397–400, 2015. (3) Gyu Yeul Ji, M.D.,1,3 Chang Hyun Oh, M.D.,1 Daeyeong Chung, M.D.,2 and Dong Ah Shin, M.D., Ph.D.Spinal Subdural Hematoma Following Cranial Subdural Hematoma : A Case Report with a Literature Review.J Korean Neurosurg Soc. 54(6): 515–517, 2013. (4) Jain V, Singh J, Sharma R. Spontaneous concomitant cranial and spinal subdural haematomas with spontaneous resolution. Singapore Med J.49(2) : e53, 2008. (5) Daniel S. Treister,1 Sara E. Kingston,1 Gabriel Zada,2 Manu Singh,1 Jesse G. A. Jones,1 Jena N. Mills,1 Alexander Lerner,1 Orest B. Boyko,1 Meng Law,1 Anandh Rajamohan,1 and Mark S. Shiroishi1. Concurrent Intracranial and Spinal Subdural Hematoma in a Teenage Athlete: A Case Report of This Rare Entity.Hindawi Publishing Corporation Case Reports in Radiology. Article ID 143408, 5 pages, 2014. (6)Naoshi Hagihara, Toshi Abe, Kazuyuki Kojima, Mitsuo Watanabe, Kazuo Tabuchi. Coexistence of Cranial and Spinal Subdural Hematomas. Neurol Med Chir. 50,333~335,2010. (7)Satoshi YamaGuchi, Kaoru Kurisu, Kazunori Arita, Masaaki Takeda, Itaru Tani, Osamu Araki.Simultaneous Cranial and Spinal Subdural Hematoma. Neurol Med Chir. 45,645~649, 2005. (8)A. Sari, B. Sert, H. Dinc, K. Kuzeyli. SUBACUTE SPINAL SUBDURAL HEMATOMA ASSOCIATED WITH INTRACRANIAL SUBDURAL HEMATOMA.Journal of Neuroradiology. Vol 33, N° 1-février pp. 67-69, 2006. (9)Wonjun Moon, Wonil Joo, Jeongki Chough, Haekwan Park.Spontaneous Spinal Subdural Hematoma Concurrent with Cranial Subdural Hematoma.Journal of Korean Neurosurgical Society. 54(1): 68-70, 2013. (10)Hideki Nagashima, Atsushi Tanida, Ikuta Hayashi, Shinji Tanishima, Yoshiro Nanjo, Toshiyuki Dokai & Ryota Teshima.Spinal subdural haematoma concurrent with cranial subdural haematoma: Report of two cases and review of literature. British Journal of Neurosurgery. Volume 24, Issue 5, 2010.

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