Horiuchi Kaoru, Toriumi Hayato, Iida Jun-ichi, Nakase Hiroyuki, Sakaki Toshisuke
Department of Neurosurgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, Nara 634-8522, Japan.
No To Shinkei. 2005 Dec;57(12):1095-8.
Spontaneous spinal epidural hematomas (SSEH) are relatively rare clinical entities and associated with coagulopathies, tumors, or vascular malformation. In addition, these are often neurosurgical emergencies; therefore, prompt diagnosis and treatment are paramount. We reported a case of an 87-year-old woman with spontaneous cervical epidural hematoma. She presented with the sudden onset of neck pain, rt. upper arm sensory disturbance and rt. hemiparesis. MRI revealed a C3-Th1 dorsally placed extradural lesion. The lesion was iso-to hypointense on T1-weighted images and was hyperintense on T2-weighted images. She underwent surgery within 9 hours after symptom onset, removal of hematoma through the right hemilaminectomy was performed. She was a very high age, but she was discharged from the hospital without neurological deficit. To obtain good prognosis for patients with SSEH, early diagnosis and treatment are important. We also review the current literature concerning diagnosis and treatment of SSEH.
自发性脊髓硬膜外血肿（SSEH）是相对罕见的临床病症，与凝血功能障碍、肿瘤或血管畸形相关。此外，这些病症通常属于神经外科急症；因此，迅速诊断和治疗至关重要。我们报告了一例87岁女性自发性颈段硬膜外血肿的病例。她表现为突发颈部疼痛、右上肢感觉障碍和右半身轻瘫。MRI显示C3 - Th1水平有一个位于背侧的硬膜外病变。该病变在T1加权图像上呈等信号至低信号，在T2加权图像上呈高信号。她在症状出现后9小时内接受了手术，通过右侧半椎板切除术清除了血肿。她年龄很大，但出院时没有神经功能缺损。为使SSEH患者获得良好预后，早期诊断和治疗很重要。我们还回顾了有关SSEH诊断和治疗的当前文献。
