Song Kyung-Jin, Lee Kwang-Bok
Department of Orthopaedic Surgery, College of Medicine, Institute for Medical Science, Chonbuk National University Medical School, Chonju, Korea.
J Korean Med Sci. 2005 Apr;20(2):331-4. doi: 10.3346/jkms.2005.20.2.331.
We present two patients who had acute paraplegia with sensory loss due to spontaneous spinal epidural hematoma (SSEH). One had myocardial infraction and the other had deep vein thrombosis, and the former was treated with anticoagulants and the latter was treated with thrombolytic agent. We analyzed the neurological status of our two cases each between its preoperative and postoperative state. Postoperatively both showed no improvement of neurologic symptom, and on follow-up of 12 months, one showed no neurologic improvement and the other showed a insignificant improvement of lower extremity muscle power (trace knee extensor/ankle dorsi-flexor). We thought that this poor outcome was due to delayed operation, which was done more than 24 hr after the symptom onset. The outcome in SSEH is essentially determined by the time taken from symptom onset to operation. Therefore, early and precise diagnosis such as careful history taking and MRI evaluation is necessary.
我们报告了两名因自发性脊髓硬膜外血肿（SSEH）导致急性截瘫并伴有感觉丧失的患者。其中一名患者患有心肌梗死，另一名患有深静脉血栓形成，前者接受了抗凝治疗，后者接受了溶栓治疗。我们分析了这两名患者术前和术后的神经状态。术后两人的神经症状均未改善，在12个月的随访中，一人神经功能未改善，另一人下肢肌肉力量有轻微改善（膝伸展肌/踝关节背屈肌痕迹）。我们认为这种不良结果是由于手术延迟，即在症状出现后超过24小时才进行手术。SSEH的结果基本上取决于从症状出现到手术的时间。因此，早期精确诊断，如仔细询问病史和进行MRI评估是必要的。
