Spontaneous spinal subarachnoid hemorrhage: a case report and literature review / 中华老年医学杂志

ABSTRACT

Objective To investigate the clinical,laboratory and MRI imaging features of a spontaneous spinal subarachnoid hemorrhage(S-SAH)so as to improve the recognition of spontaneous (S-SAH).Methods The data of clinical,laboratory,MRI imaging features,treatment and prognosis of the spontaneous(S-SAH)were collected and statistically analyzed.Relevant literatures were then reviewed.Results The patient was a 75-year-old woman with neuromyelitisoptica spectrum disorders.During the course of hospitalization for intravenous infusion of high-dose methylprednisolone,the patient suffered from a sudden and severe migrating back pain that gradually progressed from the back to the neck and head,and signs of meningeal irritation occurred.After the exclusion of aortic dissection,acute coronary syndrome,pulmonary embolism,and fractures,further MRI scans of the head and spinal cord were performed.The MRI confirmed subarachnoid hemorrhage located in spinal cord and posterior cranial foss,and the diagnosis was spontaneous S-SAH.Conclusions Migrating back pain combined with signs of meningeal irritation is a characteristic clinical manifestation of S-SAH,and a prompt MRI evaluation of spinal cord is helpful to improve the early diagnosis and treatment.