Introduction:
Spontaneous subdural hematoma (SSDH) is a rare condition resulting in
cord compression and is associated with significant mortality and
morbidity. Spinal SDH can be secondary to anticoagulation therapy, blood
dyscrasia, spinal puncture, trauma, spinal anesthesia or vascular
malformation. However, spontaneous SDH is rare, and pathophysiology is
still unknown(1).
Rupture of the vasculature within the subarachnoid or subdural space has
been proposed as a potential pathogenic mechanism in certain cases.
While some suggest that the bleeding originates from the subarachnoid
vessels with concomitant rupture into the subdural space following an
increase in intra-abdominal or intra-thoracic pressure, others have
proposed an alternative theory that the bleeding begins in the subdural
space itself (2).
The clinical manifestations of SSDH are related to cord compression and
vary from back pain to motor, sensory, and autonomic dysfunction (3, 4).
The main approach for confirming the diagnosis is magnetic resonance
imaging (MRI)(5). Although surgical intervention through decompression
is considered as the main treatment option, percutaneous drainage or
conservative therapies are also introduced. There is still controversy
about the best therapeutic strategy(4).
In this report, we present a case of cervical SSDH who presented with
acute left side weakness with no identifiable cause.