RESUMEN
Split cord malformations are disorders of gastrulation. Disorders of secondary neurulation occur later and are traditionally considered separate from the former. Complex split cord malformations involving both the cord and the conus and encompassing the epochs of gastrulation, primary neurulation, junctional neurulation, and secondary neurulation have not been described in literature. We present a four-year-old boy with such a malformation and postulate the embryological mechanism involved. The clinical vignette of this unique case has been described. We report a good clinical outcome in this patient with surgical management.
RESUMEN
The appearance of a subdural hematoma (SDH) following spinal anesthesia is a serious and rare complication which mandates prompt diagnosis, although the treatment modalities are not well codified. Patients with post-dural puncture headache (PDPH) non-responsive to conservative measures and/or those patients with a change of the character of the headache should be considered seriously. In symptomatic patients, evacuation of SDH is essential but epidural blood patch should be strongly considered as it can prevent reappearance of SDH by sealing the dural defect.