Teaching NeuroImage: Spontaneous idiopathic spinal subdural hematoma
Citation Manager Formats
Make Comment
See Comments

A 54-year-old woman with autosomal dominant polycystic kidney disease, who had received a renal transplant 10 years previously, came to our attention for acute low back pain, associated with fecal and urinary incontinence. General examination was unremarkable. Neurologic examination showed a T7 level of hypoesthesia, paraparesis, and Babinski sign bilaterally. Emergency spine MRI revealed acute subdural hematoma at T6-T8 level (figure, A–C), which was surgically evacuated.
Figure Sagittal T2-WI (A), unenhanced T1-WI (B), and axial T2-WI (C), showing a slightly T1-hyperintense and relatively T2-isohypointense circumferential extramedullary hematoma (arrows), compressing the spinal cord
The dura, visible as a thin linear T2 hypointensity (arrowheads), is not displaced, because the hematoma is subdural in location. A more common epidural hematoma would have displaced the dura away from the bony canal.
There was no evidence of vascular malformations intraoperatively and both in early postoperative spinal MRI and delayed spinal angiography. Screening for bleeding disorders was unremarkable. The patient’s neurologic status was normal at the 6-month follow-up.
Among the 19 cases with idiopathic spontaneous spinal subdural hematoma reported in the literature,1 no patient had polycystic kidney disease, a condition which has been associated with vascular fragility.2
Footnotes
-
Disclosure: The authors report no disclosures.
Series editor: Mitchell S.V. Elkind MD, MS, Section Editor
REFERENCES
Disputes & Debates: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Related Articles
- No related articles found.