Cervical spinal subarachnoid hematoma caused by head injury

Spinal subarachnoid hematoma (SSAH) is a rare condition. Most of the cases are associated with some predisposing factors such as coagulopathy or iatrogenic mechanisms. To the best of our knowledge, only 9 cases of traumatic SSAH without coagulopathy have been reported in the English literature. We add hereby a case of cervical SSAH after blunt head trauma in a 63-year-old female, with tetraparesis developing in 3 days after the head injury. Evacuation of the SSAH was performed. The postoperative course was uneventful, but the patient's neurological status had no improvement. No vascular lesion accounting for the SSAH was found. The possible causes of SSAH and the treatment outcome are discussed and compared with the results of the published case reports. Since SSAH cases are extremely rare, the diagnosis may be delayed if no obvious clinical neurologic deficits are present initially. Emergency room physicians should be aware of the possibility of SSAH in image studies.