Severe delayed diffuse cerebral vasospasm and cerebral infarctions following spinal subdural hemorrhage

Background.

We report a rare case of severe delayed cerebral vasospasm with cerebral infarctions after spinal subdural hemorrhage.

Case report. A 56-year-old woman presented with an acute onset of paraplegia. MR-imaging revealed an extensive intraspinal hemorrhage reaching from T1 to L1. The hematoma was evacuated via a T8-laminectomy. At the 7^th postoperative day the patient developed visual disturbances. MR-scanning revealed extensive infarctions and cerebral angiography showed severe diffuse vasospasms.

Interpretation. This case demonstrates that cerebral vasospasm may be caused by a spinal subdural hemorrhage, supporting the hypothesis that cerebral vasospasm may be triggered by factors from a remote site and that a direct contact of blood clots with the vessel is not mandatory.