Cervical Spine Contusion Complicated by Intraspinal Subdural Hematoma and Brachial Plexus Injury: Report of a Case

A 25-year-old man developed neck pain, Horner's syndrome, and monoplegia immediately after a motorcycle accident. The patient had worn a safety helmet and had fellen from the motorcycle. Then he struck the ground with his left arm hyperextended. The computed tomogram of the neck showed a compressive, intraspinal mass extending cranio-caudally from C1 to C7. Sagittal T1- and T2-weighted magnetic resonance images of the spine revealed subdural bleeding, and marked the extension of the hematoma to the T1 level. This case was unusual in that the hematoma was located in the cervical region and the patient did not have any correlated neurologic deficits related to cervical spine injury with subdural hematoma. The only neurologic deficit was correlated to brachial plexus injury. Traumatic cervical subdural hematoma is very rare, and only two cases have been reported in the literature. This report suggests the possible role of conservative management for traumatic cervical subdural hematoma, especially when the patient has no significant neurologic deficits related to the hematoma.