Kirazli Yesim, Akkoc Yesim, Kanyilmaz Selcen
Department of Physical Medicine and Rehabilitation, Medical Faculty of Ege University, Bornova-Izmir, Turkey.
Am J Phys Med Rehabil. 2004 Mar;83(3):220-3. doi: 10.1097/01.phm.0000107498.91919.44.
Spontaneous spinal epidural hematoma is an uncommon cause of spinal cord compression. It may be associated with various causative factors, but in many patients, anticoagulation can be implicated. It is noteworthy that many of the reported cases were anticoagulated in the therapeutic range. Spontaneous spinal epidural hematoma should be suspected in any patient receiving anticoagulant agents who complains of local or referred spinal pain associated with limb weakness, sensory deficits, or urinary retention. Early diagnosis and treatment are very important for the functional recovery of the patient. Spinal magnetic resonance imaging is the most suitable neuroradiological method for early diagnosis. Although primary management is the surgical evacuation of the spinal epidural hematoma via laminectomy, rare cases in which the patient is improving rapidly and progressively could be treated conservatively. A 22-yr-old man with a spontaneous spinal epidural hematoma who was receiving warfarin treatment for a mechanical aortic valve is presented in this article.
自发性脊髓硬膜外血肿是脊髓压迫症的一种罕见病因。它可能与多种致病因素相关，但在许多患者中，抗凝治疗可能是一个诱因。值得注意的是，许多报道的病例都处于抗凝治疗范围内。对于任何正在接受抗凝剂治疗且主诉有与肢体无力、感觉障碍或尿潴留相关的局部或牵涉性脊柱疼痛的患者，都应怀疑存在自发性脊髓硬膜外血肿。早期诊断和治疗对患者的功能恢复非常重要。脊髓磁共振成像（MRI）是早期诊断最合适的神经放射学方法。虽然主要治疗方法是通过椎板切除术对脊髓硬膜外血肿进行手术清除，但对于少数病情迅速且逐渐好转的病例，可以采取保守治疗。本文介绍了一名22岁接受华法林治疗机械主动脉瓣的自发性脊髓硬膜外血肿男性患者。
