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Concomitant Intracranial and Lumbar Chronic Subdural Hematoma Treated by Fluoroscopic Guided Lumbar Puncture: A Case Report and Literature Review
- Source :
- Neurologia medico-chirurgica
- Publication Year :
- 2018
- Publisher :
- Japan Neurosurgical Society, 2018.
-
Abstract
- A 40-year-old man presented with a severe headache, lower back pain, and lower abdominal pain 1 month after a head injury caused by falling. Computed tomography (CT) of the head demonstrated bilateral chronic subdural hematoma (CSDH) with a significant amount in the left frontoparietal region. At the same time, magnetic resonance imaging (MRI) of the lumbar spine also revealed CSDH from L2 to S1 level. A simple drainage for the intracranial CSDH on the left side was performed. Postoperatively, the headache was improved; however, the lower back and abdominal pain persisted. Aspiration of the liquefied spinal subdural hematoma was performed by a lumbar puncture under fluoroscopic guidance. The clinical symptoms were dramatically improved postoperatively. Concomitant intracranial and spinal CSDH is considerably rare so only 23 cases including the present case have been reported in the literature so far. The etiology and therapeutic strategy were discussed with a review of the literature. Therapeutic strategy is not established for these two concomitant lesions. Conservative follow-up was chosen for 14 cases, resulting in a favorable clinical outcome. Although surgical evacuation of lumbosacral CSDH was performed in seven cases, an alteration of cerebrospinal fluid (CSF) pressure following spinal surgery should be reminded because of the intracranial lesion. Since CSDH is well liquefied in both intracranial and spinal lesion, a less invasive approach is recommended not only for an intracranial lesion but also for spinal lesion. Fluoroscopic-guided lumbar puncture for lumbosacral CSDH following burr hole surgery for intracranial CSDH could be a recommended strategy.
- Subjects :
- Adult
Male
medicine.medical_specialty
Abdominal pain
Case Report
Spinal Puncture
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Lumbar
Hematoma, Subdural, Intracranial
Back pain
medicine
Humans
low back pain
Lumbar Vertebrae
medicine.diagnostic_test
business.industry
Lumbar puncture
Head injury
medicine.disease
Magnetic Resonance Imaging
Low back pain
Surgery
chronic subdural hematoma
Fluoroscopy
Chronic Disease
Hematoma, Subdural, Spinal
spinal subdural hematoma
Neurology (clinical)
medicine.symptom
Tomography, X-Ray Computed
business
030217 neurology & neurosurgery
Lumbosacral joint
Subjects
Details
- ISSN :
- 13498029 and 04708105
- Volume :
- 58
- Database :
- OpenAIRE
- Journal :
- Neurologia medico-chirurgica
- Accession number :
- edsair.doi.dedup.....8914d3991d8753e0027638203efeb663