Kim Hyun Gon, Kim Tae Wan, Park Kwan Ho, Chi Moon Pyo
Department of Neurosurgery, VHS Medical Center, Seoul, Korea.
Korean J Neurotrauma. 2014 Oct;10(2):146-8. doi: 10.13004/kjnt.2014.10.2.146. Epub 2014 Oct 31.
Traumatic spinal subdural hematoma associated with intracranial subdural hematoma is a rare condition. Herein, we report the case of a 62-year-old man with lower back pain, radiating pain, and numbness in both lower extremities, without motor weakness, for 2 weeks. Lumbar magnetic resonance imaging (MRI) revealed high signal intensity on T1-weighted image (WI), and low signal intensity on T2-WI from L2 to L5. Two weeks after conservative management, follow-up lumbar MRI did not show the hematoma and his symptoms were relieved and there was no neurological deficit; therefore, he was discharged. However, subsequently, intracranial subdural hematoma increased and upper extremity motor weakness appeared. This was treated surgically. If there is no neurological deficit, conservative treatment may be a good option. Follow-up evaluation for asymptomatic cranial subdural hematoma is necessary.
创伤性脊髓硬膜下血肿合并颅内硬膜下血肿是一种罕见的病症。在此,我们报告一例62岁男性病例,其下背部疼痛、放射性疼痛以及双下肢麻木2周,无运动无力症状。腰椎磁共振成像(MRI)显示在T1加权像(WI)上呈高信号强度,在T2加权像上从L2至L5呈低信号强度。保守治疗两周后,腰椎MRI复查未显示血肿,其症状缓解且无神经功能缺损,因此出院。然而,随后颅内硬膜下血肿增大并出现上肢运动无力。对此进行了手术治疗。如果没有神经功能缺损,保守治疗可能是一个不错的选择。对无症状的颅内硬膜下血肿进行随访评估是必要的。