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Moore JM, Jithoo R, Hwang P. Idiopathic Spinal Subarachnoid Hemorrhage: A Case Report and Review of the Literature. Global Spine J. 2015;5(5):e59-64doi: 10.1055/s-0035-1546416.
Moore, J. M., Jithoo, R., & Hwang, P. (2015). Idiopathic Spinal Subarachnoid Hemorrhage: A Case Report and Review of the Literature. Global spine journal, 5(5), e59-64. https://doi.org/10.1055/s-0035-1546416
Moore, Justin M, et al. "Idiopathic Spinal Subarachnoid Hemorrhage: A Case Report and Review of the Literature." Global spine journal vol. 5,5 (2015): e59-64. doi: https://doi.org/10.1055/s-0035-1546416
Moore JM, Jithoo R, Hwang P. Idiopathic Spinal Subarachnoid Hemorrhage: A Case Report and Review of the Literature. Global Spine J. 2015 Oct;5(5):e59-64. doi: 10.1055/s-0035-1546416. Epub 2015 Apr 29. PMID: 26430603; PMCID: PMC4577320.
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Global Spine J. 2015 Oct;5(5):e59-64. doi: 10.1055/s-0035-1546416. Epub 2015 Apr 29.

Idiopathic Spinal Subarachnoid Hemorrhage: A Case Report and Review of the Literature.

Global spine journal

Justin M Moore, Rondhir Jithoo, Peter Hwang

Affiliations

  1. Department of Neurosurgery, The Alfred Hospital, Melbourne, Victoria, Australia.

PMID: 26430603 PMCID: PMC4577320 DOI: 10.1055/s-0035-1546416

Abstract

Study Design Case report. Objective Spinal subarachnoid hemorrhage (SSAH) makes up less than 1.5% of all the cases of subarachnoid hemorrhage. Most cases of spontaneous SSAH occur in association with coagulopathy, lumbar punctures, or minor trauma. Idiopathic SSAH is extremely rare with only 17 cases published. Idiopathic SSAH presents a diagnostic dilemma, and the appropriate investigations and treatment remain a matter of controversy. We report a case of idiopathic SSAH and a review of the literature regarding its clinical presentation, diagnosis, and treatment. Methods A 73-year-old woman presented to the emergency department after spontaneously developing severe right leg and lower back pain while bending over to vomit. After a review of the patient's history and examination, the magnetic resonance imaging (MRI) of the thoracolumbar spine revealed T1 hyperintensity and T2 hypointensity, a diffusion-restricted collection at the T11-T12 level, and a posterior collection from L3 to S1 producing a mild displacement of the thecal sac. Results The patient was taken for an L5 laminectomy. Intraoperatively, rust-colored, xanthochromic fluid was drained from the subarachnoid space, confirming SSAH. The thecal sac was decompressed. The cultures and Gram stains were negative. Computer tomography (CT) and CT angiography of the brain were normal. She recovered postoperatively with resolution of the pain and no further episodes of hemorrhage after 2 years of follow-up. Repeat thoracolumbar MRI, selective spinal angiogram, and six-vessel cerebral angiogram did not reveal pathology. Conclusion We suggest a clinical algorithm to aid in the diagnosis and management of such patients.

Keywords: diagnosis; guideline; idiopathic; spinal; spontaneous; subarachnoid hemorrhage; treatment

References

  1. No Shinkei Geka. 1975 Jul;3(7):593-7 - PubMed
  2. J Neurosurg. 2000 Jul;93(1 Suppl):180-1 - PubMed
  3. Acta Neurochir (Wien). 1999;141(10):1115-7 - PubMed
  4. Acta Neurochir (Wien). 2005 Jul;147(7):741-50; discussion 750 - PubMed
  5. Neurosurgery. 1997 Sep;41(3):691-3; discussion 693-4 - PubMed
  6. Spine (Phila Pa 1976). 1987 Sep;12(7):716-8 - PubMed
  7. J Med Case Rep. 2013 Dec 23;7:274 - PubMed
  8. Surg Neurol. 1995 Aug;44(2):133-6 - PubMed
  9. Neurosurg Rev. 2003 Jan;26(1):1-49 - PubMed
  10. J Neurosurg Sci. 2001 Mar;45(1):53-7 - PubMed
  11. Acta Neurochir (Wien). 2010 Nov;152(11):1981-4 - PubMed
  12. Tohoku J Exp Med. 2013;231(2):139-44 - PubMed
  13. Spinal Cord. 2000 Mar;38(3):192-6 - PubMed
  14. Neurol Med Chir (Tokyo). 1990;30(11 Spec No):842-7 - PubMed
  15. Spinal Cord. 2004 Sep;42(9):545-7 - PubMed
  16. J Neurosurg. 1966 Oct;25(4):443-6 - PubMed
  17. Neurology. 1979 Jun;29(6):872-6 - PubMed
  18. J Korean Neurosurg Soc. 2009 Apr;45(4):253-5 - PubMed
  19. Case Rep Med. 2013;2013:934143 - PubMed
  20. J Neurosurg. 1985 Oct;63(4):636-9 - PubMed
  21. J Korean Neurosurg Soc. 2008;44(1):40-2 - PubMed
  22. Radiology. 1996 May;199(2):409-13 - PubMed
  23. Emerg Radiol. 2010 Jan;17(1):69-72 - PubMed

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