Spinal subdural haematoma as a complication of cranial surgery |
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Authors: | J I Lee S C Hong |
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Institution: | (1) Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, KR |
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Abstract: | Summary ?Background. Spinal subdural haematoma is a rare condition usually associated with several precipitating factors including coagulopathy,
lumbar puncture, trauma, vascular malformation and previous spinal surgery. In this paper we report spinal subdural haematoma
related to cranial surgery which is a previously unknown precipitating factor.
Method. The medical records of six patients in whom spinal subdural haematoma developed after cranial surgery was reviewed retrospectively
for clinical presentation, radiological findings, treatment, and outcome.
Findings. Six patients presented with low back pain and radiculopathy in the lower extremity after surgery for intracranial lesions.
Symptom onset was between 2 and 9 days after cranial surgery. Initial cranial procedures were craniotomy and tumour removal
in 1 patient, clipping of aneurysm in 1, temporal lobectomy for epilepsy in 4. None of the patients had previously known precipitating
factors for spinal subdural haematoma. In all of them, the diagnosis was confirmed by magnetic resonance (MR) imaging and
the spinal segment involved was the lower lumbar and sacral level except for one patient with a wide distribution of haematoma
over the thoracolumbar region. All patients recovered completely without surgical intervention.
Interpretation. Spinal subdural haematoma is a rare but possible complication of cranial surgery. It should be considered in patients with
back pain and radiculopathy in the lower extremity developing after surgery for intracranial lesions. Unlike spontaneous spinal
subdural haematoma with other precipitating factors, spinal subdural haematoma developing after cranial surgery takes a benign
clinical course and resolves spontaneously over several days to 2 weeks without surgical intervention.
Published online May 19, 2003 |
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Keywords: | : Spinal subdural haematoma craniotomy complication |
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