Szkup P, Stoneham G
Department of Medical Imaging, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon SK S7N 0W8, Canada.
Br J Radiol. 2004 Oct;77(922):881-4. doi: 10.1259/bjr/58217479.
Spontaneous epidural haematoma is rare in pregnancy and only five cases have been reported. We present a case of a 31-year-old female G2P1 who at 32 weeks of gestation developed progressive ascending paralysis and numbness to a level of approximately T4. An urgent MRI of the spine was performed, which demonstrated a posterior epidural lesion at T1-T4 level. The lesion showed signal changes consistent with an epidural haematoma in the hyperacute stage. An emergency cesarean section was performed followed by spinal decompression and removal of an epidural haematoma. The patient's neurological function subsequently improved. The diagnosis and management of spontaneous epidural haematoma in pregnancy is presented with a review of the literature.
自发性硬膜外血肿在孕期罕见,仅有5例报道。我们报告一例31岁女性,孕2产1,孕32周时出现进行性上行性麻痹及麻木,平面达T4左右。行脊柱紧急MRI检查,显示T1 - T4水平硬膜外病变。该病变信号改变符合超急性期硬膜外血肿表现。行急诊剖宫产,随后行脊柱减压及硬膜外血肿清除术。患者神经功能随后改善。本文结合文献复习,介绍孕期自发性硬膜外血肿的诊断与处理。