외상성 구개강내 출혈과 동반된 척추경막하 출혈; 요추 전자부 자연흡수

Traumatic Spinal Subdural Hematoma Accompanying intracranial hematoma: Spontaneous Resolution after Pumbar Puncture

  • 이원태 (조선대학교 의과대학 신경외과학교실) ;
  • 김석원 (조선대학교 의과대학 신경외과학교실)
  • Lee, Won Tae (Department of Neurosurgery, College of medicine, Chosun University) ;
  • Kim, Seok Won (Department of Neurosurgery, College of medicine, Chosun University)
  • 투고 : 2006.06.16
  • 심사 : 2006.07.21
  • 발행 : 2006.06.30

초록

A traumatic spinal subdural hematoma is a rare condition, and only nine cases have been reported until now. We report a rare case of concomitant intracranial hemorrhage and spinal subdural hematoma with a review of the literature. A 45-year-old man was referred to our institute after being stroke by a car. He complained of nausea, headache, back pain, and bilateral sciatica. Brain computed tomography and lumbar spine magnetic resonance images revealed both an intracerbral hemorrhage and a subdural hematoma in the L4 to S1 level. After performing a lumbar spinal puncture and draining the hemorrhagic cerebrospinal fluid (CSF), the intracranial and spinal hematomas were resolved completely without any neruologic deficits.

키워드

참고문헌

  1. Russell NA, Benoit BG. Spinal subdural hematoma. A review. Surg Neurol 1983;20:133-7 https://doi.org/10.1016/0090-3019(83)90464-0
  2. Hung KS, Lui CC, Wang CH, Wang CJ, Howng SL. Traumatic spinal subdural hematoma with spontaneous resolution. Spine 2002;27:534-8 https://doi.org/10.1097/00007632-200212150-00024
  3. Juvonen T, Tervonen O, Ukkola V, Klintrup HE. Widespread posttraumatic spinal subdural hematoma-imaging findings with spontaneous resolution: case report. J Trauma. 1994;36:262-4 https://doi.org/10.1097/00005373-199402000-00024
  4. Lee JI, Hong SC, Shin HJ, Eoh W, Byun HS, Kim JH. Traumatic spinal subdural hematoma: rapid resolution after repeated lumbar spinal puncture and drainage. J Trauma 1996;40:654-5 https://doi.org/10.1097/00005373-199604000-00026
  5. Chen HJ, Liang CL, Lu K, Liliang PC, Tsai YD. Cauda equina syndrome caused by delayed traumatic spinal subdural hematoma. Injury 2001;32(6):505-7 https://doi.org/10.1016/S0020-1383(01)00046-8
  6. Paredes ES, Kishore PR, Ward JD. Cervical spinal subdural hematoma. Surg Neurol 1981; 15:477-9 https://doi.org/10.1016/S0090-3019(81)80045-6
  7. RADER JP. Chronic subdural hematoma of the spinal cord: report of a case. N Engl J Med 1955;253:374-6 https://doi.org/10.1056/NEJM195509012530906
  8. Shimada Y, Sato K, Abe E, Miyakoshi N, Tsutsumi Y. Spinal subdural hematoma. Skeletal Radiol 1996;25:477-80 https://doi.org/10.1007/s002560050118
  9. Stewart DH Jr, Watkins ES. Spinal cord compression by chronic subdural hematoma. Case report.J Neurosurg 1969;31:80-2 https://doi.org/10.3171/jns.1969.31.1.0080
  10. Zilkha A, Nicoletti JM. Acute spinal subdural hematoma. Case report. J Neurosurg 1974;41:627-30 https://doi.org/10.3171/jns.1974.41.5.0627
  11. Haines DE, Harkey HL, al-Mefty O. The 'subdural' space: a new look at an outdated concept. Neurosurgery 1993;32:111-20 https://doi.org/10.1227/00006123-199301000-00017
  12. Boukobza M, Haddar D, Boissonet M, Merland JJ. Spinal subdural hematoma: a study of three cases. Clin Radiol. 2001;56:475-80 https://doi.org/10.1053/crad.2000.0466
  13. Levy JM. Spontaneous lumbar subdural hematoma. AJNR Am J Neuroradiol. 1990;11:780-1
  14. Nicholas DS, Weller RO. The fine anatomy of the human spinal meninges. A light and scanning electron microscopy study. J Neurosurg 1988;69:276-82 https://doi.org/10.3171/jns.1988.69.2.0276
  15. Domenicucci M, Ramieri A, Ciappetta P, Delfini R. Nontraumatic acute spinal subdural hematoma: report of five cases and review of the literature. J Neurosurg (1 Suppl) 1999;91:65-73