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[自发性脊髓硬膜外血肿]

[Spontaneous spinal epidural hematoma].

作者信息

García Garcia M E, de Las Heras V, Kurtis Urra M, Vela Souto I

机构信息

Departamento de Neurología, Hospital Clínico de San Carlos, Madrid, Spain.

出版信息

Neurologia. 2008 Jan-Feb;23(1):59-61.

Abstract

Spontaneous spinal epidural hematoma Spinal epidural hematoma is defined as spontaneous when there is no known underlying cause or predisposing bleeding factor. Its incidence is very low, approximately one per million inhabitants per year. However, it may cause acute and irreversible neurological symptoms. For this reason, it is considered a neurosurgical emergency that requires rapid diagnosis and treatment. The most common clinical presentation involves acute vertebral pain with radicular radiation to one or several limbs) followed by neurological signs below the lesion. Neuroradiology imaging, particularly the magnetic resonance imaging, will determine the topography and diagnosis. There are some case reports in the literature that resolved spontaneously, however, most patients require laminectomy and drainage of the hematoma. We report the case of a 65 year-old woman with a background of hypertension, who presented with an acute pain syndrome in the interscapular region radiating to both upper limbs, followed by right sided hemiparesis, as the initial symptom and sign of a spontaneous spinal epidural hematoma.

摘要

自发性脊髓硬膜外血肿 当不存在已知的潜在病因或易患出血因素时,脊髓硬膜外血肿被定义为自发性的。其发病率非常低,每年每百万居民中约有一例。然而,它可能导致急性且不可逆的神经症状。因此,它被视为一种需要快速诊断和治疗的神经外科急症。最常见的临床表现为急性脊椎疼痛并向一个或多个肢体放射神经根痛,随后出现病变以下的神经体征。神经放射学成像,尤其是磁共振成像,将确定病变部位并做出诊断。文献中有一些自发缓解的病例报告,然而,大多数患者需要进行椎板切除术和血肿引流。我们报告了一例65岁患有高血压的女性病例,该患者最初表现为肩胛间区域急性疼痛综合征并放射至双上肢,随后出现右侧偏瘫,这是自发性脊髓硬膜外血肿的初始症状和体征。

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