Figure - PMC

Skip to main content

An official website of the United States government

Here's how you know

Here's how you know

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

View full-text article in PMC

. 2024 Aug 28;166(1):353. doi: 10.1007/s00701-024-06240-6

Search in PMC
Search in PubMed
View in NLM Catalog
Add to search

© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

PMC Copyright notice

Fig. 3 — Case 1: 39-year-old man with spontaneous spinal subdural hematoma. A 39-year-old male patient presented to the emergency department ten days after a COVID infection, reporting symptoms such as fever, fatigue, and back pain persisting for one week. The patient had experienced intermittent episodes of back pain, self-treated with aspirin as needed before seeking medical attention. Subsequently, the patient developed a severe headache and meningism. There was no history of trauma, coagulation disorder, or other pre-existing diseases. Coagulation and infection parameters in the laboratory results were observed to be within typical ranges. Neurological examination revealed, except for meningism, no further neurological deficits. Gadolinium-enhanced MRI and MR angiography (MRA) identified the presence of subdural hematoma along the cervical and thoracic spine, initially without a clearly identified structural source of bleeding (A). Additional spinal DSA was conducted, revealing a small suspicious lesion situated within the left lateral spinal canal at the T3/4 level (B + D). Surgical intervention, specifically a hemilaminectomy at T3 and T4 on the left side, was conducted. No definite vascular malformation was found except for pathologically coagulated veins. Postoperatively, the patient presented with hemihypesthesia below T6 on the left side, proximal paresis of the left leg (MRC 3/5), and bladder/bowel dysfunction. A subsequent gadolinium-enhanced MRI revealed residual pathological hypervascularization at T3/4 on the left (C). A re-operation with an extended approach was performed as follows: The midline skin incision was reopened, and the left L3 hemilaminectomy was extended cranially. The dura was reopened, and a likely thrombosed hemangioblastoma with associated vessels was exposed and excised. Motor-evoked potentials remained stable throughout the procedure. Following the second surgery, the patient manifested without further neurological deficits as previously described. Postoperative digital subtraction angiography revealed no residual vascular irregularities and histopathologic examination identified the lesion as vascular malformation. He was transferred to a rehabilitation center on postoperative day (POD) 2