Laus M, Alfonso C, Giunti A
Cattedra di Patologia dell'Apparato Locomotore, Università di Bologna.
Chir Organi Mov. 1991 Jul-Sep;76(3):229-36.
Three cases of nerve compression causing lumbosciatic pain and/or cruralgia due to hematoma secondary to coagulopathies of varying etiology are described. The cases involved a multiple nerve root syndrome of the cauda equina due to extradural hematoma in coagulopathy resulting from the administration of dicumarol drugs, a neuropathy of the crural nerve caused by hematoma of the iliopsoas muscle in hemophilia B, and a neuropathy of the sciatic nerve caused by hematoma in the gluteus and thigh in coagulopathy resulting from the administration of dicumarol drugs. In all three of the cases the clinical picture resembled that of lumbar disc herniation, but a careful evaluation of each patient's history, objective picture, and laboratory and radiological testing allowed us to make a correct diagnosis. Medical therapy is based on the correction of the coagulopathy by means of suitable drugs or hemoderivates. Surgical treatment is reserved for the most severe cases.
本文描述了3例因不同病因的凝血病继发血肿导致神经受压，引起腰腿痛和/或小腿痛的病例。这些病例包括：因服用双香豆素类药物导致凝血病，进而出现硬膜外血肿引起的马尾多神经根综合征；乙型血友病患者髂腰肌血肿导致的股神经病变；服用双香豆素类药物导致凝血病，进而出现臀肌和大腿血肿引起的坐骨神经病变。所有这3例病例的临床表现均类似于腰椎间盘突出症，但通过对每位患者的病史、客观体征以及实验室和影像学检查进行仔细评估，我们得以做出正确诊断。药物治疗基于使用合适的药物或血液制品纠正凝血病。手术治疗仅适用于最严重的病例。
