Brinar Marko, Rados Marko, Habek Mario, Poser Charles M
University Department of Internal Medicine, Zagreb School of Medicine and University Hospital Center, Kispatićeva 12, Zagreb, Croatia.
Clin Neurol Neurosurg. 2006 Mar;108(3):284-9. doi: 10.1016/j.clineuro.2005.11.023. Epub 2005 Dec 22.
Intramedullary spinal tumours are uncommon lesions that can cause significant difficulties in the differential diagnosis between inflammatory diseases such as multiple sclerosis and acute disseminated encephalomyelitis, and vascular malformations or neoplasms. We report five cases in which the history and the clinical symptoms suggested an inflammatory process of the spinal cord but the MRI characteristics were those of neoplastic lesions. Both non-neoplastic and neoplastic intramedullary lesion may have very similar symptoms, and even CSF abnormalities, but in every one of our cases, a more detailed history and longer observation of the clinical course would have led to the correct diagnosis; in such problem cases, empirical treatment and a follow-up MRI after a month's observation would be a more prudent approach providing that the patient is not rapidly deteriorating.
脊髓内肿瘤是罕见的病变，在鉴别诊断诸如多发性硬化症和急性播散性脑脊髓炎等炎症性疾病与血管畸形或肿瘤时会造成很大困难。我们报告了5例病例，其病史和临床症状提示为脊髓的炎症过程，但MRI特征却显示为肿瘤性病变。非肿瘤性和肿瘤性脊髓内病变可能具有非常相似的症状，甚至脑脊液也会出现异常，但在我们的每一例病例中，更详细的病史和对临床病程的更长时间观察本可得出正确诊断；在这类疑难病例中，倘若患者病情没有迅速恶化，经验性治疗并在观察一个月后进行随访MRI检查将是一种更为审慎的做法。
