Traumatic spinal subdural hematoma: An illustrative case and series review

We present an illustrative case of traumatic spinal SDH managed conservatively, and systematically review reports of traumatic spinal SDH for variables predictive of a favorable outcome. A systematic review was performed including demographic, clinical, and radiographic variables extracted from case studies. t-tests, Pearson's Chi-squared, and Fischer's Exact test were used to determine group differences in outcome. Fifty-eight reported cases, including our illustrative case, met inclusion criteria. The majority of patients were male (66.7%) with a mean age of 41.3 ± 24.7 years. Most traumas were minor (62.1%) with those presenting after a direct spinal trauma more likely to have a poor outcome. Common presenting symptoms included back pain (N = 45, 77.6%), radiculopathy (N = 33, 56.9%), and subjective weakness (N = 39, 67.2%). Neurologic deficit was present in 51.7% of patients, and in all those with a poor outcome (p < 0.001). Favorable outcome was reported in 47 patients (81.0%) and concomitant cranial SDH was statistically more common in this group (61.7%, p = 0.002). In trauma patients presenting with back pain, weakness, or neurologic deficits, spinal SDH should be considered in the differential. Reassurance and conservative management can often be first-line therapy, and presence of cranial SDH may suggest a favorable outcome. Neurologic deficit and cord compression on presentation are associated with poor outcome and warrant urgent surgi...
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research