title: [Acute non-traumatic extensive subdural spinal hematoma].
abstract: Acute spinal subdural hematoma is a somewhat rare pathology. Its severity comes from the constitution of an acute spinal cord compression. In many cases MRI is useful for the differential diagnosis with the epidural hematoma. A 79-year-old patient was referred for emergency neurosurgery for acute spinal cord compression. The vascular risk in this patient was significant: hypertension, oral anticoagulants. Clinically, acute non-traumatic subdural spinal hematoma was suspected. The spinal cord MRI was in favor of the diagnosis which was confirmed intraoperatively. The surgical procedure revealed an extensive hematoma which infiltrated the spinal cord. The diagnosis of nontraumatic subdural spinal hematoma may be difficult in some cases and correctly established only during the surgical procedure. In comparison with reports in the literature, we discuss the underlying mechanisms of this hematoma. Spinal subdural haematoma must be considered in patients taking anticoagulant therapy or with a coagulation disorder who present signs of acute spinal cord compression. MRI sagittal T1 and T2-weighted images are adequate and reliable for diagnosis of spinal subdural hematoma. Prompt surgical evacuation of this hematoma is crucial.
authors.affiliation: Service de neurochirurgie, hôpital Bretonneau, 2 bis, boulevard Tonnellé, 37044 Tours cedex, France. ndriokad@yahoo.fr
authors.forename: D
authors.initials: D
authors.lastname: N'dri Oka
authors.forename: B
authors.initials: B
authors.lastname: Aesch
authors.forename: M
authors.initials: M
authors.lastname: Jan
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D013116:Spinal Cord / Q000473:pathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000601:surgery
chemical_list: D000925:Anticoagulants