Intramedullary hemorrhage and concurrent occipital subarachnoid hemorrhage. Case presentation
Keywords:
intramedullary hemorrhage, subarachnoid hemorrhage, neurological urgencyAbstract
A 62-year-old patient was presented, with a history of systemic arterial hypertension and cerebral infarction. He went to the guard because 24 hours after intense physical exertion, he had headache and severe cervical pain, vomiting not preceded by nausea and loss of consciousness and when he woke up he could not move his legs. The physical examination revealed meningeal signs, flaccid paraplegia, loss of tactile, thermal and painful sensitivity to the level of the second rib and the tone of the bladder and anal sphincters. Computed axial tomography of the skull showed the presence of Fisher 3 bilateral occipital subarachnoid hemorrhage and the contrasted dorsal spine magnetic resonance revealed late subacute intramedullary hemorrhage. The relevance of the history, physical examination and diagnostic means, especially magnetic resonance imaging for the clinical diagnosis of intramedullary hemorrhage, is considered.
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