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Spinal subdural hygroma

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Abstract

A spinal subdural hygroma is a rare entity. In this review, we try to contribute to the pooling of current knowledge about spinal subdural hygroma, from embryology and physiology until radiological detection and treatment. The relevant articles in the literature regarding spinal subdural hygroma were reviewed, using a sensitive search strategy on Internet databases. A spinal subdural hygroma is associated with trauma, iatrogenic causes, spontaneous intracranial hypotension headache, and probably meningitis. MR imaging is the golden standard for diagnosis. Treatment of the hygroma is almost always conservative and surgery is seldom necessary, however treating the underlying cause is important. The physiology, in spite of numerous suggestions and hypotheses in literature, remains unclear. The prevalence of spinal subdural hygroma is also still unknown. Only a few articles deal with spinal subdural hygroma, because it is an uncommon entity, without specific symptoms. Probably it is often not diagnosed because of the frequent association with other cranial or spinal pathologies and the need for high-resolution imaging. More research is required to examine the prevalence, importance, and pathophysiology of spinal subdural hygroma.

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References

  1. Mack J, Squier W, Eastman JT (2009) Anatomy and development of the meninges: implications for subdural collections and CSF circulation. Pediatr Radiol 39:200–210

    Article  PubMed  Google Scholar 

  2. Rico-santos M, Villafani J, Sáiz A, Nacarino PO (2015) Progressive back pain due to epidural hygroma: an infrequent complication of lumbar puncture in adults. BMJ Case Rep 2:1–2

    Google Scholar 

  3. Mokri B (2001) The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology 56(12):1746–1748

    Article  CAS  Google Scholar 

  4. Wilson MH (2016) Monro-Kellie 2.0: the dynamic vascular and venous pathophysiological components of intracranial pressure. J Cereb Blood Flow Metab 36(8):1338–1350

    Article  PubMed  PubMed Central  Google Scholar 

  5. Medina JH, Abrams K, Falcone S, Bhatia RG (2010) Spinal imaging findings in spontaneous intracranial hypotension. Am J Roentgenol 195(2):459–464

    Article  Google Scholar 

  6. Anatomy S (2016) Anatomy of the spinal meninges. Oper Neurosurg 12(2):168–188

    Article  Google Scholar 

  7. Drake RL, Vogl AW, Mitchell AWM (2010) Gray’s anatomy for students. Elsevier Inc, Amsterdam

    Google Scholar 

  8. Darwish HA, Oldfield EH (2016) Lumbar subdural cerebrospinal fluid collection with acute cauda equina syndrome after posterior fossa decompression for Chiari malformation Type I: case report. J Neurosurg Spine 25:328–331

    Article  PubMed  Google Scholar 

  9. Lee KS (1998) The pathogenesis and clinical significance of traumatic subdural hygroma. Brain Inj 12(7):595–603

    Article  CAS  PubMed  Google Scholar 

  10. Yousry I et al (2001) Cervical MR imaging in postural headache: MR signs and pathophysiological implications. Am J Neuroradiol 22(7):1239–1250

    CAS  PubMed  Google Scholar 

  11. Kranz PG, Luetmer PH, Diehn FE, Amrhein TJ, Tanpitukpongse TP, Gray L (2016) Myelographic techniques for the detection of spinal CSF leaks in spontaneous intracranial hypotension. Am J Roentgenol 206(1):8–19

    Article  Google Scholar 

  12. Schievink W, Jacques L (2003) Recurrent spontaneous spinal cerebrospinal fluid leak associated with ‘nude nerve root’ syndrome: case report. Neurosurgery 53(5):1216–1219

    Article  PubMed  Google Scholar 

  13. Schievink W, Morreale V, Atkinson J, Meyer F, Piepgras D, Ebersold M (1998) Surgical treatment of spontaneous spinal cerebrospinal fluid leaks. J Neurosurg 88(2):243–246

    Article  CAS  PubMed  Google Scholar 

  14. Schievink WI (2006) Spontaneous spinal cerebrospinal fluid and ongoing investigations in this area. JAMA 295(19):2286–2296

    Article  CAS  PubMed  Google Scholar 

  15. Kranz PG, Amrhein TJ, Gray L (2017) CSF venous fistulas in spontaneous intracranial hypotension: imaging characteristics on dynamic and CT myelography. Am J Roentgenol 2:1–7

    Google Scholar 

  16. Wang X et al (2015) Surgical treatments for infantile purulent meningitis complicated by subdural effusion. Med Sci Monit 21:3166–3171

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Osborn AG (2013) Osborn’s brain: imaging, pathology and anatomy. Amirsys, Salt Lake city

    Google Scholar 

  18. Khurana A, Brousil J, Russo A, Evans A, Quraishi NA, Boszczyk BM (2013) Intracranial hypotension with a sixth cranial nerve palsy subsequent to massive thoracic CSF hygroma: a rare complication of thoracic disc excision. Eur Spine J 22(9):2047–2054

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Singleton WGB, Ramnarine D, Patel N, Wigfield C (2011) Post-operative spinal subdural extra-arachnoid hygroma causing cauda equina compression: a report of two cases. Br J Neurosurg 8697:22085250

    Google Scholar 

  20. Elder BD, Ishida W, Goodwin RC, Bydon A (2017) Iatrogenic spinal subdural extra-arachnoid hygroma following uncomplicated lumbar decompression. Cureus 9(4):1–6

    Google Scholar 

  21. Uzuki FS, Itagawa TK, Akagi KT, Ozaki KN (2011) Subacute subdural hygroma and presyrinx formation after foramen magnum decompression with duraplasty for chiari type 1 malformation. Neurol Med Chir 51:389–393

    Article  Google Scholar 

  22. Zachenhofer I, Donat M, Roessler K (2012) The combination of a programmable valve and a subclavicular anti-gravity device in hydrocephalus patients at high risk for hygromas. Neurol Res 34(3):219–222

    Article  PubMed  Google Scholar 

  23. Openshaw H, Ressler JA, Snyder DS (2008) Lumbar puncture and subdural hygroma and hematomas in hematopoietic cell transplant patients. Bone Marrow Transplant. 41(9):791–795

    Article  CAS  PubMed  Google Scholar 

  24. Staudinger T et al (1998) subdural hygromas after bone marrow transplantation: results of a prospective study. Transplantation 65(10):1340–1344

    Article  CAS  PubMed  Google Scholar 

  25. van den Berg JSP, Sijbrandy SE, Meijer AH, Oostdijk AH (2002) Subdural hygroma: a rare complication of spinal anesthesia. Anesth Analg 94(6):1625–1627

    Article  PubMed  Google Scholar 

  26. Vien C, Marovic P, Ingram B (2016) Case report epidural anesthesia complicated by subdural hygromas and a subdural hematoma. 1:1–5

  27. Fishman R, Dillon W (1993) Dural enhancement and cerebral displacement secondary to intracranial hypotension. Neurology 43(3):609–611

    Article  CAS  PubMed  Google Scholar 

  28. Schievink WI, Maya MM, Moser FG, Tourje J (2005) Spectrum of subdural fluid collections in spontaneous intracranial hypotension. J Neurosurg 103(4):608–613

    Article  PubMed  Google Scholar 

  29. Weindling SM, Kotsenas AL (2005) Spontaneous craniospinal hypotension. J Magn Reson Imaging 22(6):804–809

    Article  PubMed  Google Scholar 

  30. Bonneville JF, Cattin F, Bonneville F (2011) Enlargement of the inferior intercavernous sinus: a new sign for the diagnosis of craniospinal hypotension. Am J Neuroradiol 32(10):2011

    Article  Google Scholar 

  31. Smith M, Dormont R, Prather G (1951) Subdural effusions complicating bacterial meningitis. Pediatrics 7:34

    Article  CAS  PubMed  Google Scholar 

  32. Kumar R, Arora G, Bal C, Sharma P, Mishra A, Tripathi M (2013) Post meningitis subdural hygroma: anatomical and functional evaluation with 99m Tc-ehylene cysteine dimer single photon emission tomography/computed tomography. Indian J Nucl Med 28(1):23

    Article  PubMed  PubMed Central  Google Scholar 

  33. Idowu OE, Olumide AA (2009) Hydrocephalus and subdural effusion with extracranial extension complicating meningitis. J Trop Pediatr 56(5):348–350

    Article  PubMed  Google Scholar 

  34. Hobbs C, Childs A-M, Wynne J, Livingston J, Seal A (2005) Subdural haematoma and effusion in infancy: an epidemiological study. Arch Dis Child 90(9):952–955

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Fobben S, Hackney DB, Zimmerman RA, Bilaniuk LT (1989) MR characteristics hematomas and of subdural hygromas at 1.5 T. Am J Neuroradiol 153:589–595

    CAS  Google Scholar 

  36. Lee KS (2016) Chronic subdural hematoma in the aged, trauma or degeneration? J Korean Neurosurg Soc 59(1):1–5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Ahn JH et al (2016) Analysis of risk factor for the development of chronic subdural hematoma in patients with traumatic subdural hygroma. 59(6):622–627

  38. Bortolotti C, Wang H, Fraser K, Lanzino G (2004) Subacute spinal subdural hematoma after spontaneous resolution of cranial subdural hematoma: causal relationship or coincidence? Case report. J Neurosurg 100(4):372–374

    PubMed  Google Scholar 

  39. Moscovici S et al (2011) Do cranial subdural hematomas migrate to the lumbar spine? J Clin Neurosci 18(4):563–565

    Article  CAS  PubMed  Google Scholar 

  40. Li C, Yew A, Lu D (2013) Migration of traumatic intracranial subdural hematoma to lumbar spine causing radiculopathy. Surg Neurol Int 4(1):81

    Article  PubMed  PubMed Central  Google Scholar 

  41. Pham MH, Tuchman A, Platt A, Hsieh PC (2016) Intracranial complications associated with spinal surgery. Eur Spine J 25:888–894

    Article  PubMed  Google Scholar 

  42. Davidson B et al (2017) Spontaneous intracranial hypotension: a review and introduction of an algorithm for management. World Neurosurg 101:343–349

    Article  PubMed  Google Scholar 

  43. Shi B, Zheng X, Min S, Zhou Z, Ding Z, Jin A (2014) The morphology and clinical significance of the dorsal meningovertebra ligaments in the cervical epidural space. Spine J 14(11):2733–2739

    Article  PubMed  Google Scholar 

  44. Beck J et al (2017) Cerebrospinal fluid outflow resistance as a diagnostic marker of spontaneous cerebrospinal fluid leakage. J Neurosurg Spine 27(August):227–234

    Article  PubMed  Google Scholar 

  45. Parmar H, Park P, Brahma B, Gandhi D (2008) Imaging of Idiopathic Spinal Cord Herniation. Radiographics 28(2):511–8

  46. Berg-Johnsen J, Ilstad E, Kolstad F, Züchner M, Sundseth J (2014) Idiopathic ventral spinal cord herniation: an increasingly recognized cause of thoracic myelopathy. J Cent Nerv Syst Dis 6:85–91

    Article  PubMed  PubMed Central  Google Scholar 

  47. Yi CK, Biega TJ, Burgos RM (2014) Spontaneous resolution of idiopathic lumbar subdural hygroma on CT myelography and lumbar spine MRI. BMJ Case Rep. bcr2014206223

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Authors and Affiliations

  1. AZ Sint-Lucas Brugge, Sint-Lucaslaan 29, 8310, Bruges, Belgium

    Bernard Sneyers & Kristof Ramboer

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  1. Bernard Sneyers
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  2. Kristof Ramboer
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Correspondence to Bernard Sneyers.

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Sneyers, B., Ramboer, K. Spinal subdural hygroma. Acta Neurol Belg 121, 311–319 (2021). https://doi.org/10.1007/s13760-020-01558-1

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  • DOI: https://doi.org/10.1007/s13760-020-01558-1

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