• Andrea Iaquinandi, Federica Novegno, Adolfo De Luna, and Maurizio Salvati.
• Department of Neurosurgery, Policlinico "Tor Vergata", University of Rome ''Tor Vergata'', Rome, Italy. Electronic address: andrea.iaquinandi1987@gmail.com.
• World Neurosurg. 2022 Apr 1; 160: 44-49.

ObjectiveSpinal subdural hematoma (SSH) is a rare entity and the etiology has yet to be elucidated. Holocordic spinal hematomas represent an exception. The management of these patients remains controversial, due to their rarity and their extremely poor prognosis.MethodsElectronic databases (MEDLINE, Scopus, and PubMed) were analyzed for studies published through April 2021, searching holocordic spinal subdural hematoma. Case reports, case series, and literature reviews were included.ResultsWe found only 7 cases describing holocordic SSH reported in the literature, and we added the description of 1 case we managed at our institution, reaching a total of 8 cases. We discuss clinical and radiologic features, etiologic hypothesis, treatment strategies, and prognostic factors.ConclusionsThe correct treatment of holocordic hematomas is not yet well standardized. Complete evacuation is not amenable, but surgical evacuation based on magnetic resonance imaging has shown to be the most effective therapeutic option, crucial in terms of prognosis, even if performed with some delay.Copyright © 2022 Elsevier Inc. All rights reserved.

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