Migration of an Intracranial Subdural Hematoma to the Spinal Subdural Space: A Case Report

• Published in: Korean Journal of Spine Vol. 12; no. 3; pp. 207 - 209
• Main Authors: Kwon, O Ik, Son, Dong Wuk, Kim, Young Ha, Kim, Young Soo, Sung, Soon Ki, Lee, Sang Weon, Song, Geun Sung
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Spinal Neurosurgery Society 01.09.2015; 대한척추신경외과학회
• Subjects: Case Report; 신경외과학; Intracranial subdural hematoma; Subarachnoid space; Spinal injuries; Cerebrospinal fluid; Spinal subdural hematoma
• ISSN: 1738-2262; 2586-6583; 2093-6729; 2586-6591
• DOI: 10.14245/kjs.2015.12.3.207

A 57-year-old man complained of severe lower back pain and radicular pain in both legs for 1 week after falling from a ladder. Magnetic resonance imaging (MRI) of the spine showed a subdural hematoma (SDH), which was surgically removed. The patient had no back pain or the radicular leg pain at 2 weeks post-surgery. However, he complained of diffuse headaches upon follow-up. Brain computed tomography (CT) and MRI revealed an intracranial SDH, which was immediately removed by surgery. During his 1-year follow-up, he reported that the pain had resolved without recurrence. Simultaneous spinal and intracranial SDH are rare and no standard treatment exists for this condition. This case suggests that it is possible that an intracranial SDH can migrate into the cerebrospinal fluid (CSF) space through an arachnoid tear. CSF circulation allows the intracranial SDH to enter subarachnoid spaces encasing the spinal cord. In order to prevent irreversible damage, surgical intervention should be considered for case of spinal SDH with progressive neurological deficits.