Simultaneous Cranial Subarachnoid Hemorrhage-Subdural Hematoma and Spinal Subarachnoid Hemorrhage

Abstract

Patients with traumatic intracranial subarachnoid hemorrhage (SAH) rarely develop spinal subarachnoid hemorrhage (SSAH) without direct spinal injury. We present the case of a 76-yearold male patient with traumatic intracranial SAH and subdural hematoma, back pain and weakness in the both lower limbs radiating to the legs three days after the trauma. After worsening of pain and numbness, the patient underwent a lumbar magnetic resonance imaging 7 days after the trauma, in which blood was seen in the spinal canal in the lumbosacral region. The bleeding was considered SSAH because of the liquid level. The patient underwent conservative treatment because the patient was found to be at high cardiac risk and the neurological deficit was mild. In patients with traumatic intracranial hemorrhage and delayed pain or neurological deficits, SSAH should be suspected in the first period of trauma.

Keywords

• intracranial bleeding
• spinal subarachnoid hemorrhage
• back pain
• magnetic resonance imaging