Spinal cord changes after the evacuation of a spinal subdural haematoma

Spinal subdural haematoma is a rare entity. Only a few cases have been repo rted, mainly in patients with coagulopathies or bleeding diathesis, and als o in patients undergoing anticoagulant therapy following surgery, trauma, o r lumbar puncture. Symptoms of spinal cord compression produced by spinal s ubdural haematoma may progress rapidly causing complete and irreversible de ficits. However, rapid diagnosis and surgical intervention can result in a good functional outcome for the patient. We report on a 41-year-old woman w ith a normal coagulation profile who developed a spinal subdural haematoma after a minor motor vehicle accident. Although initially asymptomatic, she developed a dense quadriparesis over a 36-h period. A magnetic resonance im aging study demonstrated a subdural mass compressing the spinal cord, and a t surgery a spinal subdural haematoma was found. She was discharged to an i npatient rehabilitation facility. Follow-up at 1 year showed significant im provement in motor function, but absence of posterior column function. A fo llow-up magnetic resonance study demonstrated widening of the spinal cord, advanced myelomalacia and a large, central, multi-loculated syrinx.