Idiopathic Spinal Subdural Hematoma: Case Report and Review of the Literature

Abstract

Background: To the best of our knowledge, there are 20 cases of idiopathic subdural hematoma (SDH), with only 1 case of idiopathic SDH located in the cervical region. We report a case of idiopathic spinal SDH and review the literature on this disease.

Case description: A 43-year-old man experienced sudden onset of continuous, needle-like neck pain for 3 days with paresthesias and paraplegia. He denied any history of trauma, had no family history of bleeding diathesis, and was not on anticoagulation therapy. Hematologic investigations, liver function tests, and coagulation profile all were within reference range, and preoperative craniocerebral computed tomography was normal. Magnetic resonance imaging showed a massive compression hematoma located in the spinal canal at C2-5 level in the sagittal view and a semicircular compression hematoma in the axial view. At 1 week after C2-5 level laminectomy and evacuation of the hematoma, the patient's motor power in the left arm and left leg was improved (grades 4/5 and 5/5, respectively).

Conclusions: SDH represents an emergency that could lead to significant neurologic deficit and warrants great concern. Magnetic resonance imaging is the best imaging method to diagnose this disease.

Keywords: Idiopathic; Spinal hematomas; Spinal subdural hematoma.