Baker Michelle L, Hand Peter J, Tange Damien
Melbourne Neuroscience Centre, The Royal Melbourne Hospital, Grattan Street, Parkville, 3050, Victoria, Australia.
J Clin Neurosci. 2008 Mar;15(3):313-6. doi: 10.1016/j.jocn.2006.09.011. Epub 2008 Jan 10.
This paper is a case report of Terson's Syndrome (TS) in spontaneous spinal subarachnoid haemorrhage (SAH). A 66-year-old woman with acute onset of severe back pain was transferred to our institution for management of her sciatica. The presence of an intraretinal haemorrhage alerted us to consider intracranial SAH, but investigations showed no intracranial source. Eventually, the patient was diagnosed with a thoracic spinal SAH. The patient's symptoms gradually improved with conservative management but within 1 month she had a recurrence. A spinal and CT angiogram did not elicit the aetiology. The diagnosis of spontaneous spinal SAH can be difficult. The recognition of TS has important prognostic implications, often heralding subarachnoid rebleeding. Fundoscopic examination appears mandatory as a tool for diagnosis and regular non-invasive monitoring of patients with SAH.
本文是一例自发性脊髓蛛网膜下腔出血(SAH)合并Terson综合征(TS)的病例报告。一名66岁女性,急性起病,严重背痛,因坐骨神经痛被转诊至我院治疗。视网膜内出血的出现提醒我们考虑颅内SAH,但检查未发现颅内出血源。最终,患者被诊断为胸段脊髓SAH。经保守治疗,患者症状逐渐改善,但1个月内复发。脊髓和CT血管造影未明确病因。自发性脊髓SAH的诊断可能困难。认识TS具有重要的预后意义,常预示蛛网膜下腔再出血。眼底检查作为SAH患者诊断和定期无创监测的工具似乎必不可少。