Idiopathic Spontaneous Intramedullary Hemorrhage: A Report of a Rare Case of Repeated Intramedullary Hemorrhage with Unknown Etiology

Korean Journal of Spine
Byeong Sam Choi, Sungjoon Lee

Abstract

A 48-year-old woman presented with acute voiding difficulty, numbness and weakness of both lower extremities. Magnetic resonance imaging (MRI) showed an intramedullary hemorrhagic mass that extended from T9 to T10. T8-T10 laminotomy and surgical removal of the hemorrhagic mass was performed. The pathological diagnosis was hematoma. Her neurological status remained the same after the operation. At 5 days post-operation, the patient suddenly became paraplegic, and MRI that was immediately performed revealed a recurrent intramedullary hemorrhage. Emergent surgical evacuation was performed. Again, histological examination showed only hematoma, without any evidence of abnormal vessels or a tumor. A postoperative MRI revealed no abnormal lesions other than those resulting from postoperative changes. At a 9-month follow up, the patient could walk a short distance with the aid of a walker. Because spontaneous intramedullary hemorrhage with unknown etiology is very rare, it is essential to perform a meticulous inspection of the hemorrhagic site to find the underlying cause. Repeated hemorrhage can occur; therefore, close observation of patients after surgery is important in cases without an apparent etiology. Urgent surgical evacuation ...Continue Reading

References

Jan 1, 1988·Acta neurochirurgica·C LicataR Da Pian
May 1, 1970·Journal of Neurosurgery·W T Koos, F Böck
May 1, 1996·Spinal Cord·A KaravelisT Zarampoukas
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Sep 17, 2009·Journal of Pediatric Hematology/oncology·Roosy AulakhRam K Marwaha
Oct 3, 2012·Clinical Neurology and Neurosurgery·Chia-Hung ChaoShiuh-Lin Hwang

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Citations

Jan 29, 2021·Clinical Neurology and Neurosurgery·Ketan VermaBrian M Cameron
Jul 29, 2021·Journal of Pediatric Neurosciences·Vibhu Shankar ParasharGaurav Jaiswal

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