Idiopathic spontaneous spinal subarachnoid hemorrhage

Introduction: Spontaneous spinal subarachnoid hemorrhage (SAH) occurs in less than 1% of all cases of SAH, and idiopathic spontaneous spinal SAH is even more rare. Methods: A 48-year-old man presented with a sudden onset of low back pain without any neurological deficit. There was no history of either trauma or the use of anticoagulants. Magnetic resonance (MR) imaging of the lumbar spine revealed an intradural linear mass from T12 to L3, ventral to the conus medullais and cauda equina. The mass was of iso-signal intensity in T2-weighted images, of high signal intensity in T1-weighted images, and was not enhanced following injection of gadolium. Lumbar tapping revealed bloody cerebrospinal fluid, confirming SAH. At 1 month after the onset of symptom, his pain subsided spontaneously and no vascular abnormality was found by spinal angiography. Follow-up MR imaging confirmed the complete resolution of the SAH. Conclusion: We report a case of idiopathic spontaneous spinal SAH at the lumbar level in a 48-year-old man.