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Journal of Korean Neurosurgical Society 2009;46(2): 172-175.
doi: https://doi.org/10.3340/jkns.2009.46.2.172
Spontaneous Bilateral Supratentorial Subdural and Retroclival Extradural Hematomas in Association with Cervical Epidural Venous Engorgement.
Chul Bum Cho, Hae Kwan Park, Chung Kee Chough, Kyung Jin Lee
Catholic Neuroscience Center, Department of Neurosurgery, St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. parkoct@catholic.ac.kr
We describe a case of 36-year-old man who presented with a subacute headache preceded by a 1-month history of posterior neck pain without trauma history. Head and neck magnetic resonance imaging (MRI) studies disclosed bilateral supratentorial subdural and retroclival extradural hematomas associated with marked cervical epidural venous engorgement. Cerebral and spinal angiography disclosed no abnormalities except dilated cervical epidural veins. We performed serial follow-up MRI studied to monitor his condition. Patient's symptoms improved gradually. Serial radiologic studies revealed gradual resolution of pathologic findings. A 3-month follow-up MRI study of the brain and cervical spine revealed complete resolution of the retroclival extradural hematoma, disappearance of the cervical epidural venous engorgement, and partial resolution of the bilateral supratentorial subdural hematoma. Complete resolution of the bilateral supratentorial subdural hematoma was confirmed on a 5-month follow-up brain MRI. The diagnosis and possible mechanisms of this rare association are discussed.
Key Words: Supratentorial subdural hematoma; Retroclival extradural hematoma; Cervical epidural venous engorgement
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