Fok W M, Sun L K, Wong N M, Lau P Y, Cheung H M
Department of Orthopaedics and Traumatology, United Christian Hospital, Hong Kong.
J Orthop Surg (Hong Kong). 2007 Dec;15(3):373-5. doi: 10.1177/230949900701500327.
A 15-month-old boy presented with a 2-day history of a wry neck (bent to the left side) with no definite trauma. He had bilateral upper limb weakness and was afebrile, conscious, and stable. There was no spontaneous movement in both upper limbs. Magnetic resonance imaging of the cervical and thoracic spine demonstrated an extensive spontaneous spinal epidural haematoma from C3 to T8. 23 hours after admission, the patient underwent an emergency right-sided C3 to T8 hemi-laminectomy and haematoma evacuation. The patent's strength gradually recovered and he attained full power 3 weeks after operation. Spontaneous spinal epidural haematoma is a rare disease in children. A high index of suspicion is essential for its effective management as the interval to operation is the most important prognostic factor.
一名15个月大的男孩出现歪颈(向左侧弯曲)2天,无明确外伤史。他双侧上肢无力,无发热,意识清醒,情况稳定。双上肢无自主活动。颈椎和胸椎磁共振成像显示从C3至T8有广泛的自发性脊髓硬膜外血肿。入院23小时后,患者接受了急诊右侧C3至T8半椎板切除术及血肿清除术。患者的力量逐渐恢复,术后3周恢复至完全正常。儿童自发性脊髓硬膜外血肿是一种罕见疾病。高度怀疑对于其有效治疗至关重要,因为手术间隔时间是最重要的预后因素。