Subdural hematoma after microdiscectomy: a case report and review of the literature.
BACKGROUND
Subdural hematomas (SDHs) have been described as a rare complication from durotomy after lumbar spine surgery. In half of the reported cases, the durotomy was unnoticed intraoperatively. The most common presenting symptom was persistent headache.


OBJECTIVE
To report a case of SDH after routine microdiscectomy and to review the literature.


METHODS
Case report and review of the literature.


METHODS
Retrospective review of patient's history and imaging studies.


RESULTS
A 39-year-old female underwent routine microdiscectomy for L5-S1 herniated disc. There were no complications, and no dural tear was noted. Approximately 1 week postoperatively, the patient complained of severe headaches. Imaging revealed a right intracranial chronic SDH and a lumbar pseudomeningocele. Operative exploration of her lumbar wound revealed a dural tear, which was closed primarily. The patient had subsequent resolution of her SDH.


CONCLUSIONS
The authors present a case of a routine microdiscectomy complicated by delayed cerebrospinal leak causing a chronic SDH. This report illustrates the need for a comprehensive evaluation of headaches after spine surgery.
Beier
Alexandra D
AD
Section of Neurosurgery, Providence Hospital and Medical Centers, 16001 W Nine Mile Rd, Southfield, MI 48075, USA. alexandra.beier@gmail.com
Soo
Teck M
TM
Claybrooks
Roderick
R
D000328:Adult; D017586:Diskectomy / Q000009:adverse effects*; D005260:Female; D006408:Hematoma, Subdural / Q000209:etiology*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D011183:Postoperative Complications