PDF(Pubmed)
Abstract：
Spinal subdural hematoma (SSDH) is a rare condition where the exact pathology is unclear; coagulopathy, bleeding disorders, trauma, and iatrogenic causes are frequently associated with SSDH. SARS-CoV-2 infection and COVID-19 vaccines are unusual causes of SSDH, as reported by multiple studies. Here, we present a rare case report and a narrative review of SSDH resulting from a ruptured cerebral aneurysm. A 53-year-old female presented with an acute, severe suboccipital headache and neck and back pain without radiculopathy. Investigations for cardiovascular diseases and brain images were unremarkable. Further investigation revealed an SSDH extending from T1 to S2. Negative spinal angiography led to a cerebral angiogram, identifying an internal carotid artery ophthalmic segment aneurysm that was successfully treated with endovascular stent-assisted coiling. This case scenario of anterior circulation cerebral aneurysmal rupture manifesting as an isolated SSDH is unique compared to previously reported cases of SSDH resulting from cerebral aneurysms. This case highlights the importance of considering aneurysmal rupture in SSDH cases with no apparent underlying pathology to prevent neurological deficits. Early detection and intervention in such cases can prevent serious neurological deficits and improve patient outcomes.
摘要：
脊髓硬膜下血肿（SSDH）是一种罕见的疾病，确切的病理尚不清楚；凝血病，出血性疾病,创伤,医源性原因通常与SSDH相关。SARS-CoV-2感染和COVID-19疫苗是SSDH的不寻常原因，多项研究报告。这里,我们提供了一个罕见的病例报告，并对由脑动脉瘤破裂引起的SSDH进行了叙述性回顾。一名53岁的女性出现了急性，严重的枕下头痛和颈背痛，无神经根病。对心血管疾病和大脑图像的调查并不明显。进一步的调查显示SSDH从T1延伸到S2。脊髓造影阴性导致脑血管造影,确定经血管内支架辅助卷绕治疗成功的颈内动脉眼段动脉瘤。与先前报道的由脑动脉瘤引起的SSDH病例相比，这种表现为孤立的SSDH的前循环脑动脉瘤破裂病例是独特的。此病例强调了在没有明显潜在病理的SSDH病例中考虑动脉瘤破裂以防止神经功能缺损的重要性。在这种情况下，早期发现和干预可以预防严重的神经功能缺损并改善患者预后。
