Takemura S, Sasai K, Ohnari H, Ichikawa N, Akagi S, Iida H
1Department of Orthopaedic Surgery, Kansai Medical University, Moriguchi, Japan.
Spinal Cord. 2006 Aug;44(8):518-21. doi: 10.1038/sj.sc.3101871. Epub 2005 Dec 6.
Case report.
To describe the mechanism of injury in this case and its clinical features. Magnetic resonance (MR) images of hemorrhage in spinal cord injury due to stab wound are discussed.
We describe the case of a 21-year-old woman who was stabbed in the right side of her neck and developed left-sided Brown-Séquard syndrome plus loss of bilateral proprioceptive sensation. Neither plain radiographs nor computed tomography of the cervical spine demonstrated any foreign bodies or fractures of the cervical spine. T2-weighted cervical MR images confirm spinal cord hemiresection at C5-C6.
MR imaging was performed serially at 4 days, 4 weeks, and 8 weeks after trauma. The signal pattern of the spinal cord at the site of injury varied iso, iso, and low on T1-weighted consecutive images. Meanwhile, high signal intensity on T2-weighted images was consistent during the 8 weeks after incidence of trauma. A T2-weighted sagittal image showed a tiny spot of low intensity in the high signal band at the site of penetration, demonstrating hemosiderin formation in the spinal cord. The patient was treated conservatively and, recovered from Frankel grade C to grade D.
Spinal cord injuries (SCI) following stab wounds are rare. MR imaging is definitely useful for recording and monitoring the pathology of SCI.
病例报告。
描述该病例的损伤机制及其临床特征。讨论刺伤导致脊髓损伤出血的磁共振(MR)图像。
我们描述了一名21岁女性的病例,她颈部右侧被刺伤,出现左侧布朗 - 塞卡尔综合征并伴有双侧本体感觉丧失。颈椎的X线平片和计算机断层扫描均未显示任何异物或颈椎骨折。颈椎T2加权MR图像证实C5 - C6水平脊髓半切。
在创伤后4天、4周和8周连续进行MR成像。损伤部位脊髓在连续T1加权图像上的信号模式分别为等信号、等信号和低信号。同时,创伤发生后8周内T2加权图像上的高信号强度保持一致。T2加权矢状位图像显示在穿透部位的高信号带中有一个微小的低强度斑点,表明脊髓内有含铁血黄素形成。患者接受保守治疗,从Frankel C级恢复到D级。
刺伤后脊髓损伤(SCI)罕见。MR成像对于记录和监测SCI的病理情况肯定有用。