Sobottke R, Horch C, Lohmann U, Meindl R, Muhr G
Klinik und Poliklinik für Orthopädie des Klinikums der Universität zu Köln, Josef-Stelzmann-Strasse 9, 50924 , Köln, Germany.
Unfallchirurg. 2007 Apr;110(4):355-9. doi: 10.1007/s00113-006-1194-2.
Spontaneous spinal epidural haematoma (SSEH) is a rare and serious condition. Four cases of SSEH are presented in this paper, three of which were in the cervical segment while one involved the entire spine. In two of these four cases the diagnosis was not made until late in the course, and persisting neurological deficits resulted; one case was diagnosed early and the neurological outcome was good; and in one the decompression achieved was inadequate, owing to intraoperative complications. Laminectomy was performed in all four cases for the purpose of decompression of the spinal cord but at different intervals after the onset of symptoms and with different neurological outcomes. The prognosis of SSEH depends heavily on the time that elapses between the onset of symptoms and the surgical treatment. The diagnostic procedure of choice is MRI.
自发性脊髓硬膜外血肿(SSEH)是一种罕见且严重的病症。本文介绍了4例SSEH病例,其中3例位于颈椎节段,1例累及整个脊柱。在这4例病例中,有2例直到病程后期才得以诊断,导致神经功能缺损持续存在;1例早期诊断,神经功能结局良好;还有1例由于术中并发症,减压不充分。所有4例均进行了椎板切除术以减压脊髓,但症状出现后手术间隔时间不同,神经功能结局也不同。SSEH的预后在很大程度上取决于症状出现与手术治疗之间的时间间隔。首选的诊断方法是MRI。