Lumbosacral Subdural Hematoma and Concomitant Acute Lower Extremity Monoparesis After Intracranial Aneurysmal Subarachnoid Hemorrhage

Abstract

BACKGROUND: Spinal subdural hematoma (SDH) secondary to intracranial aneurysmal subarachnoid hemorrhage (SAH) occurs rarely and can cause neurologic deficits. CASE DESCRIPTION: A 52-year-old man was diagnosed with SAH caused by rupture of an anterior communicating artery aneurysm. The aneurysm was treated by coil embolization on the day of admission. After embolization, the patient's left lower extremity strength had decreased and a spinal magnetic resonance imaging showed subarachnoid hematoma and SDH with severe thecal sac compression at L4-S2. On postbleed day 6, L4-S1 laminectomy was performed, and the strength in all muscle of the left leg improved. CONCLUSIONS: Rupture of an intracranial aneurysm may cause symptomatic SDH in the lumbosacral spine as well as subarachnoid hematoma.