Bortolotti Carlo, Wang Huan, Fraser Kenneth, Lanzino Giuseppe
Department of Neurosurgery, Illinois Neurological Institute, University of Illinois College of Medicine at Peoria, Illinois 61637, USA.
J Neurosurg. 2004 Apr;100(4 Suppl Spine):372-4. doi: 10.3171/spi.2004.100.4.0372.
The etiopathogenesis of traumatic spinal subdural hematoma (SSH) is uncertain. Unlike the supratentorial subdural space, no bridging veins traverse the spinal subdural space. The authors describe a case of subacute SSH that occurred after spontaneous resolution of traumatic intracranial SDH and suggest a causal relationship between the two. A 23-year-old woman suffered an acute intracranial SDH after a snowboarding accident. There was no clinical or radiological evidence of spine injury. Conservative management of the supratentorial SDH resulted in spontaneous radiologically documented resolution with redistribution of blood in the subdural space. Four days after the injury, the patient started noticing new onset of mild low-back pain. The pain progressively worsened. Magnetic resonance imaging of the lumbosacral spine 10 days after the original injury revealed a large L4-S2 SDH. Ten days after the original injury, bilateral L5-S1 laminotomy and drainage of the subacute spinal SDH were performed. The patient experienced immediate pain relief. The authors hypothesize that in some cases spinal SDH may be related to redistribution of blood from the supratentorial subdural space.
创伤性脊髓硬膜下血肿（SSH）的发病机制尚不清楚。与幕上硬膜下间隙不同，没有桥静脉穿过脊髓硬膜下间隙。作者描述了一例在创伤性颅内硬膜下血肿（SDH）自发消退后发生的亚急性SSH病例，并提出两者之间存在因果关系。一名23岁女性在一次单板滑雪事故后发生急性颅内SDH。没有脊柱损伤的临床或影像学证据。幕上SDH的保守治疗导致硬膜下间隙内血液重新分布，影像学记录显示自发消退。受伤4天后，患者开始注意到新发的轻度下背痛。疼痛逐渐加重。原始损伤10天后进行的腰骶部脊柱磁共振成像显示L4-S2水平有一个大的硬膜下血肿。原始损伤10天后，进行了双侧L5-S1椎板切开术并引流亚急性脊髓硬膜下血肿。患者疼痛立即缓解。作者推测，在某些情况下，脊髓硬膜下血肿可能与幕上硬膜下间隙血液重新分布有关。
