Kalala Okito J P, Van Damme O, Calliauw L
Department of Surgery Neurosurgical Unit, Clinique Ngaliema Kinshasa, RDC.
Acta Neurochir (Wien). 2004 Apr;146(4):407-10; discussion 410. doi: 10.1007/s00701-003-0214-z. Epub 2004 Feb 16.
Sickle cell anaemia, an autosomal recessive disease relatively common among the black races, gives rise sometimes to neurological complications. Among these, spontaneous epidural haematoma constitutes a rare event that is not always easy to treat in the Third world conditions.
Two new cases are described and their pathology is compared with the five already described cases in the literature. A vaso-occlusive pathological process as in the orbital compression syndrome is thought to be implicated in the generation of the spontaneous epidural haematoma.
When facing an epidural haematoma as a complication of sickle cell disease in a hospital of the Third world conditions, a cautious attitude towards surgery should be observed because of the high complication rate. If the relation between the haematoma and the anaemia is not immediately apparent, we are in favour of starting treatment with antibiotics.
镰状细胞贫血是一种在黑人种族中相对常见的常染色体隐性疾病,有时会引发神经并发症。其中,自发性硬膜外血肿是一种罕见事件,在第三世界条件下并不总是易于治疗。
描述了两例新病例,并将其病理与文献中已描述的五例病例进行比较。认为与眼眶压迫综合征一样的血管闭塞性病理过程与自发性硬膜外血肿的发生有关。
在第三世界条件的医院中,当面对作为镰状细胞病并发症的硬膜外血肿时,由于并发症发生率高,应采取谨慎的手术态度。如果血肿与贫血之间的关系不立即明显,我们赞成开始使用抗生素治疗。