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A Journal on Neurosurgery

Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651

Frequency: Bi-Monthly

ISSN 0390-5616

Online ISSN 1827-1855


Journal of Neurosurgical Sciences 2001 March;45(1):53-7


Spinal sub­arach­noid bleed­ing of ­unknown eti­ol­o­gy. Case ­reports

Ruelle A., Zerbi D., Andrioli G.

Department of Neurosurgery, Galliera Hospital, Genova, Italy

Spinal sub­arach­noid bleed­ing of ­unknown eti­ol­o­gy is extreme­ly ­rare. It has ­been sug­gest­ed ­that ­these ­lesions ­have to be divid­ed ­into two sub­types ­with dif­fer­ent beha­vi­our and prog­no­sis accord­ing to ­their loca­tion ­around the spi­nal ­cord. The dor­sal­ly locat­ed bleed­ing ­would invar­i­ably ­cause ­severe spi­nal ­cord com­pres­sion ­while the ven­tral ­lesions ­would ­have a ­very ­benign ­course in the ­absence of remark­able neu­ro­log­i­cal def­i­cit. We ­observed two ­patients ­with spon­ta­ne­ous spi­nal sub­arach­noid bleed­ing of ­unknown eti­ol­o­gy. In ­both cas­es the dis­ease was ­revealed by the sud­den ­onset of ­severe ­back ­pain with­out sub­se­quent ­signs of spi­nal ­cord com­pres­sion. In one ­case the bleed­ing was ven­tral to the spi­nal ­cord ­while in the oth­er it was locat­ed dor­sal­ly. The ­patients ­were eval­u­at­ed ­with pan­spi­nal MRI and selec­tive spi­nal angio­gra­phy. They ­were treat­ed con­ser­va­tive­ly and fol­low-up exam­ina­tions at 18 and 24 ­months ­show ­they are neu­ro­log­i­cal­ly ­intact in the ­absence of rebleed­ing epi­sodes. We ­think the diag­no­sis of spon­ta­ne­ous sub­arach­noid bleed­ing of ­unknown eti­ol­o­gy can­not be ­achieved with­out a pan­spi­nal MRI and a selec­tive angio­gra­phy ­have ­ruled out any oth­er caus­es. We sug­gest ­their inci­dence is ­more prev­a­lent ­than report­ed due to the dif­fi­cul­ty/reluc­tance to ­employ MR in the pres­ence of ­only ­minor symp­toms. Our cas­es ­also ­show ­that ­these ­lesions may ­have a ­benign ­course inde­pen­dent­ly ­from ­their loca­tion ­around the spi­nal ­cord.

language: English


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