Spontaneous concomitant cranial and spinal subdural haematomas with spontaneous resolution

Jain V, Singh J, Sharma R
Correspondence: Dr Raju Sharma, raju152@yahoo.com

ABSTRACT
We report a rare case of concomitant cranial and spinal subdural haematoma (SDH) in a 12-year-old boy with severe thrombocytopenia due to aplastic anaemia, and review the available literature. Magnetic resonance (MR) imaging at presentation revealed a cranial SDH confined to the posterior fossa, and spinal SDH extending from the C1 to S3 segments. The child was managed conservatively due to his poor general condition and lack of any neurological deficit. Repeat MR imaging done at six weeks showed complete resolution of the spinal SDH and partial resolution of the cranial SDH. Although rare, a spontaneous spinal SDH can occur simultaneously with a cranial SDH. Urgent surgical decompression is considered the treatment of choice for spinal SDH; however, a conservative approach may succeed in patients with poor general condition, and/or mild/no neurological deficit.

Keywords: child, cranial subdural haematoma, spinal subdural haematoma, spontaneous resolution
Singapore Med J 2008; 49(2):e53-8