Abstract
Background
Spinal subarachnoid hemorrhage (SSH) is an uncommon occurrence responsible for <1%
of all cases of subarachnoid hemorrhage (SAH).
Case Report
We present the case of a 53-year-old man who presented to the emergency department
(ED) with acute onset of “tearing” back pain that began during activity, and who was
diagnosed with an SSH that ultimately progressed to spinal cord compression.
Why Should an Emergency Physician Be Aware of This?
Although uncommon, the consequences of SSH are potentially devastating, yet reversible,
making awareness of this condition critical. Several rare yet potentially devastating
causes of acute back pain are deserving of consideration when approaching back pain
in the ED setting; SSH is among them. Pain that is described as “tearing” or that
is unresponsive to ordinary analgesic dosages should prompt strong consideration of
vascular or other serious pathology, including arterial dissection or spinal cord
compression.
Keywords
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References
- Spontaneous spinal subarachnoid hemorrhage and subdural hematoma: report of two cases.J Neurosurg. 1984; 61: 975-980
- Management of patients with acute back pain in the ED.in: Mattu A. Goyal D. Emergency medicine: avoiding the pitfalls and improving the outcomes. Blackwell Publishing, Malden, MA2007: 33-38
- Spinal subarachnoid hematomas: our experience and literature review.Acta Neurochir (Wien). 2005; 147: 741-750
- Spontaneous spinal subarachnoid hemorrhage: report of 3 cases.J Neurosurg. 1966; 25: 443-446
- Coagulopathy induced spinal intradural extramedullary haematoma: report of three cases and review of the literature.Acta Neurochir (Wien). 2001; 143: 135-140
- Nontraumatic acute spinal subdural hematoma: report of five cases and review of the literature.J Neurosurg Spine. 1999; 91: 65-73
- Intramedullary spinal cord hemorrhage (hematomyelia).Rev Neurol Dis. 2009; 6: 54-61
- Spinal subarachnoid hematoma resulting from lumbar myelography.Am J Neuroradiol. 2007; 28: 220-221
- Case report: Traumatic acute spinal subarachnoid hematoma.J Clin Neurosci. 2007; 14: 71-73
- Sudden paraplegia.J Bone Joint Surg Br. 1954; 36: 352-353
- Spinal subarachnoid hemorrhage following lumbar puncture.Arch Surg. 1960; 80: 574-577
- Spinal hematoma: a literature survey with meta-analysis of 613 patients.Neurosurg Rev. 2003; 26: 1-49
- Spontaneous spinal subarachnoid hemorrhage with spontaneous resolution.J Korean Neurosurg Soc. 2009; 45: 253-255
Article info
Publication history
Published online: January 21, 2015
Accepted:
November 16,
2014
Received in revised form:
October 16,
2014
Received:
September 5,
2014
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
