Traumatic cervical spine intradural hematoma: A case report and review of literature

Abstract

Introduction: Intradural spinal hematoma, which refers to subdural and/or subarachnoid hematomas, represent a small percentage of spinal hematoma cases, with both hematomas together being only 19.8% of all spinal hematomas. Taken individually, a traumatic cervical spine subdural hematoma is a rare presentation by itself with only 11 cases reported in literature so far. Presentation of case: A 31 years old male presented to the ER with trauma to his neck after fall from height. ASIA (American Spinal Injury Association) impairment scale showed a grade A injury with no sensory or motor function preserved in the sacral segment S4-S5, upper paraparesis and lower paraplegia. Computed Tomography scan showed fracture of C6 vertebrae. Cervical spine T1 and T2 MRI showed intradural hematoma extending from C6 to craniocervical junction. Cervical traction and corpectomy were done. Discussion: Traumatic Cervical spine intradural hematoma is a rare entity. Unlike spinal subarachnoid hematoma, spinal subdural hematomas pathophysiology is still unclear. Spinal MRI is the best imaging modality to reach the diagnosis. First line management is surgical evacuation of hematoma, but conservative management is a valid option in certain cases. Conclusion: Knowing the risk factors that increase the chance of Intradural extramedullary spinal hematomas and clinically distinguishing those who need to be managed surgically or conservatively is an important step in managing Intradural extramedullary spinal hematomas cases.