ISSN: 2041-6792

Clinical Investigation

Spinal Subdural Hematoma Innovations

 Acute spinal subdural hematoma (ASSH) is a rare cause of spinal cord compression and resultant neurological deficits. The ASSH has the potential to expand rapidly and the clot can extend over multiple levels, and if left untreated, the patient may develop compression of the neural structures and irreversible neurologic deficits. In this case, the authors report an uncommon case of ASSH following spinal injury; the patient was treated in emergency and made a good recovery in his neurological functions. A 23-year-old male patient presented with the history fall from height (electric pole). There was no history of loss of consciousness; vomiting; ear, nasal, or oral bleed; or convulsions. The patient was complaining of the weakness of the lower limbs and did not pass urine after the injury. At the time of examination in the emergency room, he was conscious; alert; and oriented to time, place, and person. He had weakness of the lower limbs of grade 2/5 with sluggish reflexes. Plantar reflex was not elicitable bilaterally. Cranial nerves were normal. Motor and sensory examination in the upper limbs was normal. Reflexes were normal in the upper limbs. He had tenderness over the upper dorsal spine level. Chest compression was positive. Pelvic compression was negative. He had reduced air on left side of the chest. His other general and systemic examination was normal. Radiograph of the chest showed multiple rib fractures on left with evidence of hemo-pneumothorax. Lateral radiograph of the dorsal spine showed fracture of the D6 vertebral body. Magnetic resonance imaging (MRI) of the dorsal spine showed compression fracture of the D5, D6, and D7 vertebral body. MRI of the spine showed mild anterior wedging of D3, D4, and D5 with vertebral body hypointense signal and severe effacement of the anterior thecal sac. There was hypointense collection seen posteriorly, which was extending from inferior endplate of C5 to superior endplate of D3  

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