Dramatic Resolution of Symptomatic Thoracolumbar Traumatic Spinal Subdural Hygroma with Lumbar Puncture: A Literature Review and Case Illustration

Subdural hygromas are excess fluid accumulations in the subdural compartment, likely occurring via tears in the arachnoid membrane causing cerebrospinal fluid (CSF) leakage into the subdural space. Treatment recommendations for spinal subdural hygromas are lacking. We report a case of a 30-year-old...

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Bibliographic Details
Published in:World neurosurgery 2020-03, Vol.135, p.19-22
Main Authors: Wilkinson, Brandon M., Oh, Justin Y., Swarnkar, Amar S., Galgano, Michael
Format: Article
Language:English
Subjects:
Accidents, Traffic
Adult
Cauda equina
Cauda Equina Syndrome - etiology
Humans
Lumbar puncture
Lumbar Vertebrae - injuries
Magnetic Resonance Imaging
Male
Motorcycles
Spinal Puncture - methods
Subdural Effusion - etiology
Subdural Effusion - surgery
Subdural hygroma
Thoracic Vertebrae - injuries
Thoracolumbar
Traumatic
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Summary:Subdural hygromas are excess fluid accumulations in the subdural compartment, likely occurring via tears in the arachnoid membrane causing cerebrospinal fluid (CSF) leakage into the subdural space. Treatment recommendations for spinal subdural hygromas are lacking. We report a case of a 30-year-old man who developed delayed-onset cauda equina syndrome after a motor vehicle accident. Magnetic resonance imaging of the thoracic and lumbar spine revealed a CSF intensity collection involving most of the thoracic spine and extending toward the distal end of the thecal sac with ventral displacement of the spinal cord and nerve roots. The patient was successfully treated using interventional radiology-guided lumbar puncture. Posttraumatic spinal subdural hygromas are rare complications, as evidenced by the lack of literature and treatment guidelines. Using lumbar puncture, we demonstrate clinical and radiographic resolution of a traumatic subdural hygroma. This outcome suggests lumbar puncture may be an effective treatment modality for similar patients, and can potentially be used to avoid a more invasive surgical decompression.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2019.11.103