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压迫脊髓圆锥并与2型神经纤维瘤病相关的脊髓蛛网膜下腔血肿

Spinal subarachnoid hematoma compressing the conus medullaris and associated with neurofibromatosis type 2.

作者信息

Inoue T, Miyamoto K, Kushima Y, Kodama H, Nishibori H, Hosoe H, Shimizu K

机构信息

Department of Orthopaedic Surgery, Gifu University School of Medicine, Tsukasamachi, Gifu City, Gifu, Japan.

出版信息

Spinal Cord. 2003 Nov;41(11):649-52. doi: 10.1038/sj.sc.3101496.

Abstract

STUDY DESIGN

Report of a case of subarachnoid hematoma associated with neurofibromatosis type 2 (NF2) in a 10-year-old girl.

OBJECTIVE

To report a rare case of subarachnoid spontaneous hematoma associated with NF2, with no evidence of trauma.

SETTING

Gifu, Japan.

METHODS

The patient presented with severe leg pain. MRI revealed a subarachnoid hematoma at the level of L2 and a spinal cord tumor at the level of T6. The subarachnoid hematoma had low and high heterogeneous signal intensity on the T1-weighted image and low signal intensity on the T2-weighted image, indicating the presence of extracellular methemoglobin. The tumor and hematoma were resected.

RESULTS

Pathological analysis demonstrated that the surgical specimen removed from the area of L2 was a hematoma and the specimen from T6 was a neurinoma. At follow-up 1 year after surgery, the girl remained neurologically asymptomatic.

CONCLUSIONS

This rare case of spinal subarachnoid hematoma was associated with NF2. MRI was useful in establishing the diagnosis.

摘要

研究设计

一名10岁女孩的2型神经纤维瘤病(NF2)相关蛛网膜下腔血肿病例报告。

目的

报告一例罕见的与NF2相关的无创伤证据的蛛网膜下腔自发性血肿病例。

地点

日本岐阜。

方法

患者表现为严重腿痛。MRI显示L2水平有蛛网膜下腔血肿,T6水平有脊髓肿瘤。蛛网膜下腔血肿在T1加权图像上呈低和高不均匀信号强度,在T2加权图像上呈低信号强度,提示存在细胞外高铁血红蛋白。肿瘤和血肿被切除。

结果

病理分析表明,从L2区域切除的手术标本为血肿,从T6切除的标本为神经鞘瘤。术后1年随访时,该女孩神经系统无症状。

结论

这例罕见的脊髓蛛网膜下腔血肿与NF2相关。MRI有助于确诊。

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