Spontaneous spinal subarachnoid haemorrhage: a not so benign disease with devastating results.

A 67-year-old male presented with sudden right hemiplegia. One hour before he had complained of mild cervicalgia, but physical examination at the time revealed neither neurological deficits nor stiffness of the neck. He had been admitted to the hospital the day before due to acute biliary pancreatitis, with elevated transaminases but normal blood coagulation testing. He had no history of trauma. Twenty minutes after the onset plegia on the left leg and moderate paresis on the left arm appeared. The level of consciousness was preserved and the cranial nerves function was normal. No clear sensory level was present. Brain CT scan demonstrated the presence of blood in the pontine cistern surrounding the brainstem (figure 1). CT of the cervical spine showed a haematoma in the cervical spine that seemed to be located in the subarachnoid space, displacing and compressing the spinal …