MÁU TỤ DƯỚI MÀNG CỨNG NGOÀI TỦY VỊ TRÍ HÀNH NÃO C1-C2 BÁO CÁO NHÂN MỘT TRƯỜNG HỢP HIẾM GẶP

Abstract

Spinal subdural hematoma is a rare condition that can lead to severe neurological sequelae and a high mortality rate if not diagnosed and treated promptly. We report a case of an 18-year-old male who was admitted to the hospital following a motorcycle accident. He was diagnosed initially with traumatic brain injury and subarachnoid hemorrhage, presenting with severe headache. On the third day of hospitalization, the patient developed worsening headache accompanied by signs of meningeal irritation. Neurological examination revealed quadriparesis with muscle strength graded 3/5. Cervical spine MRI revealed a hematoma within the spinal canal, extending from the clivus anteriorly and occipital bone posteriorly down to the C2 vertebral level. The hematoma measured approximately 35 × 24 mm, showing mildly hyperintense signals on T1W and T2W sequences and hypointense signals on T2*- consistent with hemorrhagic features. The hematoma compressed the cervical spinal cord at the C1–C2 level, causing spinal cord edema over a length of approximately 28 mm. The patient underwent posterior decompression via suboccipital craniectomy, C1 laminectomy, dural opening, hematoma evacuation, hemostasis, and neural decompression. With timely diagnosis and surgical intervention, the patient had a favorable postoperative recovery.