Kim Bo-Mi, Chang Min-Yung, Lee Seung Hyun, Ha Joong Won
Department of Radiology Orthopedic surgery, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Radiol Case Rep. 2021 Apr 13;16(6):1454-1458. doi: 10.1016/j.radcr.2021.03.041. eCollection 2021 Jun.
Spinal subdural hematoma is a rare condition presenting with symptoms of back pain and neurologic deficits. The etiology is largely idiopathic, followed by anti-coagulant use and vascular malformation. Traumatic subdural hematomas associated with compression fractures are rare, with only a few old case reports. Magnetic resonance imaging is the modality of choice for the diagnosis of spinal subdural hematoma. Treatment is surgical decompression when neurologic deficits exist; however, conservative management is a good option in patients without neurologic symptoms with reported spontaneous hematoma regression. Herein, we report 3 cases of spinal subdural hematoma, 2 spontaneous cases related to anti-platelet agent use and 1 with acute traumatic compression fracture. T1-weighted fat-saturated images clearly showed the hematoma and increased the confidence level of the diagnosis. In summary, we suggest that magnetic resonance imaging can clearly visualize the spinal subdural hematoma and is excellent for diagnosis and follow up. Anti-platelet agent use and compression fracture are probable etiologies of spinal subdural hematoma.
脊髓硬膜下血肿是一种罕见疾病，表现为背痛和神经功能缺损症状。其病因大多为特发性，其次是抗凝药物使用和血管畸形。与压缩性骨折相关的创伤性硬膜下血肿罕见，仅有少数旧病例报告。磁共振成像（MRI）是诊断脊髓硬膜下血肿的首选方式。当存在神经功能缺损时，治疗方法为手术减压；然而，对于无神经症状且有报道称血肿可自发消退的患者，保守治疗是一个不错的选择。在此，我们报告3例脊髓硬膜下血肿病例，2例为与使用抗血小板药物相关的自发病例，1例为急性创伤性压缩性骨折病例。T1加权脂肪抑制图像清晰显示了血肿，提高了诊断的可信度。总之，我们认为磁共振成像能够清晰显示脊髓硬膜下血肿，对诊断和随访非常有帮助。使用抗血小板药物和压缩性骨折可能是脊髓硬膜下血肿的病因。
