title: Concomitant Intraspinal and Retroperitoneal Hemorrhage Caused by an Aneurysm on the Celiac Artery: A Case Report.
abstract: Spontaneous spinal hemorrhage is a rare condition. We present a case in which the diagnosis was complicated by a concomitant intra-abdominal hemorrhage. The patient, taking coumarins, presented with acute back pain and abdominal pain and progressive paresis of the lower limbs. Computed tomography angiography of the abdomen showed an intra-abdominal hemorrhage and an aneurysm of the celiac trunk. MR (magnetic resonance) imaging of the spine revealed a combined subdural and epidural hemorrhage from C1 to L1. Both sites were treated conservatively. After 6 months the patient regained strength in both legs with some persistent loss of strength in the left leg. Follow-up MR imaging showed complete resolution of the spinal hemorrhage. The celiac artery aneurysm was treated conservatively. We suggest that the rupture of the celiac artery aneurysm caused increased intra-abdominal pressure leading to spinal hemorrhage. Emergency staff should be aware of the possibility of two rare but concomitant conditions.
authors.affiliation: Department of Emergency Medicine, University Hospital, Antwerp, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Vermeulen
authors.affiliation: Department of Emergency Medicine, University Hospital, Antwerp, Belgium.
authors.forename: Veerle
authors.initials: V
authors.lastname: Schwagten
authors.affiliation: Department of Neurosurgery, University Hospital, Antwerp, Belgium.
authors.forename: Tomas
authors.initials: T
authors.lastname: Menovsky
keywords: abdominal hemorrhage; celiac trunk aneurysm; coumarins; paresis; spinal hemorrhage