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J Neurol Surg Rep 2015; 76(01): e28-e31
DOI: 10.1055/s-0034-1395491
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Concomitant Intraspinal and Retroperitoneal Hemorrhage Caused by an Aneurysm on the Celiac Artery: A Case Report

Katrien Vermeulen
1   Department of Emergency Medicine, University Hospital, Antwerp, Belgium
,
Veerle Schwagten
1   Department of Emergency Medicine, University Hospital, Antwerp, Belgium
,
Tomas Menovsky
2   Department of Neurosurgery, University Hospital, Antwerp, Belgium
› Author Affiliations
Further Information

Publication History

06 June 2014

06 August 2014

Publication Date:
16 January 2015 (online)

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Abstract

Spontaneous spinal hemorrhage is a rare condition. We present a case in which the diagnosis was complicated by a concomitant intra-abdominal hemorrhage. The patient, taking coumarins, presented with acute back pain and abdominal pain and progressive paresis of the lower limbs. Computed tomography angiography of the abdomen showed an intra-abdominal hemorrhage and an aneurysm of the celiac trunk. MR (magnetic resonance) imaging of the spine revealed a combined subdural and epidural hemorrhage from C1 to L1. Both sites were treated conservatively. After 6 months the patient regained strength in both legs with some persistent loss of strength in the left leg. Follow-up MR imaging showed complete resolution of the spinal hemorrhage. The celiac artery aneurysm was treated conservatively. We suggest that the rupture of the celiac artery aneurysm caused increased intra-abdominal pressure leading to spinal hemorrhage. Emergency staff should be aware of the possibility of two rare but concomitant conditions.

Keywords

spinal hemorrhage - coumarins - celiac trunk aneurysm - paresis - abdominal hemorrhage
 

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