title: Lumbar subdural hematoma from intracranial subarachnoid hemorrhage presenting with bilateral foot drop: case report.
abstract: BACKGROUND
  We report a patient with lumbar subdural hematoma secondary to intracranial subarachnoid hemorrhage (SAH) presenting with bilateral foot drop and describe our management.
  
  
  METHODS
  A 37-year-old woman presented with grade 4 SAH and hydrocephalus requiring emergent external ventricular drainage. Angiography demonstrated a left vertebral artery dissection and pseudoaneurysm that was treated with embolization of the vertebral artery. Six days after admission, her neurologic examination significantly improved. She was awake, alert, following commands, and moving all her extremities normally except for bilateral foot drop. An MRI scan revealed a lumbar subdural hematoma with severe thecal sac compression at L4-S1. The patient was initially treated with expectant management followed by surgery after she demonstrated only modest improvement. Evacuation of the hematoma was undertaken by an L5-S1 laminectomy and drainage of the liquefied clot in the subdural, extra-arachnoid space. Postoperatively, the patient demonstrated improved strength in all muscle groups except for left lower extremity eversion.
  
  
  CONCLUSIONS
  We present a case of subdural hematoma that caused bilateral foot drop. Neurologic improvement occurred after evacuation of the hematoma.
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, California 94143, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Waldron
authors.forename: Michael C
authors.initials: MC
authors.lastname: Oh
authors.forename: Dean
authors.initials: D
authors.lastname: Chou
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D046649:Hematoma, Subdural, Spinal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome