SUBDURAL HEMORRHAGE OF THE CAUDA-EQUINA - A RARE COMPLICATION OF CEREBROSPINAL-FLUID SHUNT - CASE-REPORT

We describe the case of a 16-year-old boy with idiopathic hydrocephalu s, who developed cranial subdural hygromas and subsequent cranial subd ural hemorrhage after a shunting procedure. Sciatica and radicular lum bar pain initially seemed to be unrelated to the preceeding implantati on of a ventriculoatrial shunt. CT scan revealed a sharply demarcated hyperdensity in the lumbar subdural space with compression of the caud a equina. Differential diagnosis considerations included vascular malf ormations, vascular tumors, benign tumors of meninges or nerve sheets, ependymoma, lymphoma, and metastases. MR investigation did, in fact, clearly recognize this hyperintense space-occupying lesion as blood in the subdural space which outlined the cauda equina. We believe that t he spinal subdural hematoma in our case represented an extension of in tracranial subdural haemorrhage fluid into the spinal subdural space.