Leidinger W, Meierhofer J N, Ullrich V
Abteilung für Anästhesie und operative Intensivmedizin-Blutdepot, Klinikum Garmisch-Partenkirchen.
Anaesthesist. 2003 Aug;52(8):703-6. doi: 10.1007/s00101-003-0525-8.
An 31-year-old women with a long history of back pain without neurological symptoms underwent a caesarean section during the 36th week of pregnancy with combined spinal-epidural anaesthesia. Indication was the increasingly severe back pain. She delivered a normal healthy boy. On the 3rd day after surgery she developed a discrete sensory cauda equina syndrome on the left side. The interpretation of the magnetic resonance imaging (MRI) was a tumor in the thecal sac extending from the middle of the vertebral body of L-1 to the the superior vertebral plate of L-3. A few days later she underwent a laminectomy under general anaesthesia with resection of an intradural mass adherent to the cauda equina. Pathological review of the surgical specimen revealed a myxopapillary ependymoma WHO grade I. The postoperative course was uncomplicated with preservation of bladder dysfunction but after 4 weeks the bladder function was normalised.
一名31岁有长期背痛病史但无神经症状的女性,在妊娠36周时接受了腰麻-硬膜外联合麻醉下的剖宫产手术。手术指征是背痛日益加重。她产下一名健康男婴。术后第3天,她左侧出现轻微的马尾神经综合征。磁共振成像(MRI)显示硬脊膜囊内有一个肿瘤,从L-1椎体中部延伸至L-3上椎板。几天后,她在全身麻醉下接受了椎板切除术,切除了与马尾神经粘连的硬膜内肿物。手术标本的病理检查显示为世界卫生组织I级黏液乳头型室管膜瘤。术后过程顺利,膀胱功能保留但有功能障碍,不过4周后膀胱功能恢复正常。