Dae-Chul Cho1, Joo-Kyoung Sung. 1. Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Abstract
STUDY DESIGN: A case report. OBJECTIVE: To report a rare case of traumatic subacute spinal subdural hematoma (SDH) successfully treated by lumbar drainage. SUMMARY OF BACKGROUND DATA: Few reports on traumatic spinal SDH are available in the English literature. METHODS: The authors present a rare case of traumatic subacute spinal SDH. A 43-year-old man developed severe pain in his back and both legs approximately 3 weeks after a trivial car accident that occurred 1 month before presentation. The patient reported paresthesia in the L5 and S1 dermatomes bilaterally and a walking difficulty because of severe leg pain. He assessed his pain severity as 8 using the visual analog pain score scale. Magnetic resonance imaging of the lumbar spine revealed a spinal SDH extending from the level of the L5 vertebral body to S1-S2 disc space. RESULTS: The spinal SDH was drained by lumbar puncture at the L5-S1 level without surgical exploration. The intensity of the pain decreased considerable immediately, and he was able to walk independently. The patient recovered uneventfully and a follow-up magnetic resonance imaging conducted 4 weeks after the procedure revealed complete disappearance of the hematoma. CONCLUSIONS: Traumatic spinal SDH is extremely rare and is usually associated with intracranial injury. Here, the authors report a rare case of traumatic spinal SDH not associated with head injury, which was successfully treated by lumbar drainage.
STUDY DESIGN: A case report. OBJECTIVE: To report a rare case of traumatic subacute spinal subdural hematoma (SDH) successfully treated by lumbar drainage. SUMMARY OF BACKGROUND DATA: Few reports on traumatic spinal SDH are available in the English literature. METHODS: The authors present a rare case of traumatic subacute spinal SDH. A 43-year-old man developed severe pain in his back and both legs approximately 3 weeks after a trivial car accident that occurred 1 month before presentation. The patient reported paresthesia in the L5 and S1 dermatomes bilaterally and a walking difficulty because of severe leg pain. He assessed his pain severity as 8 using the visual analog pain score scale. Magnetic resonance imaging of the lumbar spine revealed a spinal SDH extending from the level of the L5 vertebral body to S1-S2 disc space. RESULTS: The spinal SDH was drained by lumbar puncture at the L5-S1 level without surgical exploration. The intensity of the pain decreased considerable immediately, and he was able to walk independently. The patient recovered uneventfully and a follow-up magnetic resonance imaging conducted 4 weeks after the procedure revealed complete disappearance of the hematoma. CONCLUSIONS:Traumatic spinal SDH is extremely rare and is usually associated with intracranial injury. Here, the authors report a rare case of traumatic spinal SDH not associated with head injury, which was successfully treated by lumbar drainage.