# Spinal Subdural Hematoma Secondary to Ruptured Internal Carotid Artery Ophthalmic Segment Aneurysm: A Case Report and Narrative Review

## TL;DR

A rare case of spinal subdural hematoma caused by a ruptured brain aneurysm is reported, highlighting the need for early diagnosis to prevent neurological damage.

## Contribution

This case uniquely links a ruptured internal carotid artery aneurysm to an isolated spinal subdural hematoma, expanding diagnostic considerations.

## Key findings

- A 53-year-old female presented with SSDH from T1 to S2 due to a ruptured cerebral aneurysm.
- Endovascular stent-assisted coiling successfully treated the aneurysm.
- Early detection of such cases can prevent neurological deficits and improve outcomes.

## Abstract

Spinal subdural hematoma (SSDH) is a rare condition where the exact pathology is unclear; coagulopathy, bleeding disorders, trauma, and iatrogenic causes are frequently associated with SSDH. SARS-CoV-2 infection and COVID-19 vaccines are unusual causes of SSDH, as reported by multiple studies. Here, we present a rare case report and a narrative review of SSDH resulting from a ruptured cerebral aneurysm.

A 53-year-old female presented with an acute, severe suboccipital headache and neck and back pain without radiculopathy. Investigations for cardiovascular diseases and brain images were unremarkable. Further investigation revealed an SSDH extending from T1 to S2. Negative spinal angiography led to a cerebral angiogram, identifying an internal carotid artery ophthalmic segment aneurysm that was successfully treated with endovascular stent-assisted coiling.

This case scenario of anterior circulation cerebral aneurysmal rupture manifesting as an isolated SSDH is unique compared to previously reported cases of SSDH resulting from cerebral aneurysms. This case highlights the importance of considering aneurysmal rupture in SSDH cases with no apparent underlying pathology to prevent neurological deficits. Early detection and intervention in such cases can prevent serious neurological deficits and improve patient outcomes.