Ng Wai Hoe, Lim C C Tchoyoson, Ng Puay Yong, Tan Kheng Kooi
Department of Neurosurgery, National Neuroscience Institute, Singapore.
J Clin Neurosci. 2002 Jan;9(1):92-4. doi: 10.1054/jocn.2001.0918.
Spinal epidural haematoma is a rare cause of spinal cord compression. It is most commonly attributed to trauma and coagulation disorders. We report a case of a 64 year-old man with thrombocytopaenia who presented with a traumatic epidural haematoma who p resented with right hemiparesis which progressed to complete tetraplegia. MR of the cervical spine showed an epidural collection on the posterior aspect of the cord throughout the cervical spine. The patient underwent C1-C7 laminectomy and decompression. Postoperatively, the patient has improved gradually and has power of grade 3 (Medical Research Council classification of power) in all 4 limbs at 2-month follow-up. MRI is an important modality in the early diagnosis of spinal epidural haematomas and can facilitate emergent decompressive surgery which offers the best chance of neurological improvement.
脊髓硬膜外血肿是脊髓压迫症的一种罕见病因。其最常见的原因是外伤和凝血功能障碍。我们报告一例64岁血小板减少症男性患者，该患者因外伤性硬膜外血肿出现右侧偏瘫，进而发展为完全性四肢瘫。颈椎磁共振成像显示整个颈椎脊髓后方有硬膜外血肿。患者接受了C1 - C7椎板切除术及减压手术。术后，患者逐渐好转，在2个月的随访中四肢肌力均达到3级（医学研究委员会肌力分级）。磁共振成像在脊髓硬膜外血肿的早期诊断中是一种重要的检查方法，并且有助于进行急诊减压手术，而急诊减压手术为神经功能改善提供了最佳机会。
