Work

Steroid response in a rare case of vertebrae butterfly with spinal cord compression caused by chronic subdural hematoma

Year: 2024

Type: article

Abstract: Introduction Spinal subdural hematoma (SSH) is a rare entity. Clinical symptoms include motor, sensory and/or autonomic dysfunction due to compression of the spinal cord. There is no standard consensus in the management of SSH. Here, we report a rare case of SSH of sudden onset following trauma, successfully treated with conservative therapy. Aim This case highlights butterfly vertebrae as an incidental imaging finding before SSH diagnosis. Case study A 30-year-old female presented with weakness in the lower extremities after trauma, accompanied by paresthesia, urinary retention, and impaired defecating function. The thermoregulatory sweat exam revealed sudomotor dysfunction. Multiple slice computed tomography (MSCT) examination of the whole spine revealed wedge deformity of vertebral corpus (VC) L4 on the right lateral side, and VC L5 butterfly vertebrae. Spine magnetic resonance imaging (MRI) revealed an extramedullary intradural lesion at the T7 to T10 level suggestive of subdural hematoma. Results and discussion The administration of methylprednisolone pulse therapy, combined with physical rehabilitation, led to a rapid and significant improvement in the patient's motor function. The absence of the spinal pain possibly indicated that there was no more extension of the hematoma; motor recovery, even if slight, should be a predictor of successful conservative therapy, and physical rehabilitation. Conclusions SSH is an uncommon condition, with varying clinical presentation, and progression. This case report highlights significant improvement following conservative steroid treatment of a SSH. It also highlights a unique incidental finding of butterfly vertebra in a patient with paraparesis following trauma.

Source: Polish Annals of Medicine

DOI: 10.29089/paom/193654

Authors: MUHAMMAD YUNUS AMRAN, Gita Vita Soraya, Haris Nur

Institutions: Rumah Sakit Umum Pusat Dr. Wahidin Sudirohusodo, Hasanuddin University

Language: English

Topic: Spinal Hematomas and Complications

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4403375323