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[硬膜外血贴成功治疗巴雷-利厄综合征:两例报告]

[Epidural blood patch as a successful treatment of Barrè-Lièou syndrome: report of two cases].

作者信息

Ishikawa Shinichi, Katayama Daisuke, Takahara Hiroshi, Kojo Shigeru, Moriyama Eiji, Hashimoto Hidenori

机构信息

Department of Anesthesiology, Fukuyama Kohnan Hospital, Fukuyama 720-0814.

出版信息

Masui. 2003 Dec;52(12):1305-11.

Abstract

Barrè-Lièou syndrome accompanies neurological symptoms after neck sprain, and is often difficult to treat. We describe two young men with various neurological symptoms after traffic accident, who were diagnosed with Barrè-Lièou syndrome. Both case 1 (41-year-old man) and case 2 (34-year-old man) showed no abnormal findings in head and cervical X-ray, CT-scan and MRI. Only radionuclide cisternography (RNC) showed cerebrospinal fluid (CSF) leak into epidural space at thoracolumbar level. Three months (case 1) and four years (case 2) had passed after each accident. Two patients underwent epidural blood patch (EBP) for total of three times. The average volumes of the blood used for EBP were 30 ml (case 1) and 24 ml (case 2). The procedure improved various symptoms except for neck stiffness and dizziness. EBP had led to low back pain, which disappeared within three days. CSF leak vanished in RNC after EBP. Severe complication, for example epidural infection or neurological disorders due to hematoma, was not noticed. While neural blockade did not relieve pain before EBP, we could get good effect from neural blockade for remaining symptoms after EBP. We consider that Barrè-Lièou syndrome is due to CSF leak and EBP may be one of the useful treatments.

摘要

巴雷-利厄综合征在颈部扭伤后伴有神经症状,且往往难以治疗。我们描述了两名在交通事故后出现各种神经症状的年轻男性,他们被诊断为巴雷-利厄综合征。病例1(41岁男性)和病例2(34岁男性)的头部和颈椎X线、CT扫描及MRI均未发现异常。仅放射性核素脑池造影(RNC)显示脑脊液(CSF)在胸腰段水平漏入硬膜外间隙。每次事故后分别过去了三个月(病例1)和四年(病例2)。两名患者共接受了三次硬膜外血贴(EBP)治疗。EBP所用血液的平均量分别为30毫升(病例1)和24毫升(病例2)。该操作改善了除颈部僵硬和头晕外的各种症状。EBP导致了腰痛,但在三天内消失。EBP后RNC中脑脊液漏消失。未发现严重并发症,如硬膜外感染或血肿引起的神经障碍。虽然在EBP前神经阻滞不能缓解疼痛,但对于EBP后残留的症状,神经阻滞能取得良好效果。我们认为巴雷-利厄综合征是由脑脊液漏引起的,EBP可能是一种有效的治疗方法。

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