Young V E L, Pickett G, Richardson P L, Leach P
Salford Royal Hospital, Salford, UK.
Acta Neurochir (Wien). 2008 Jul;150(7):733-5; discussion 735. doi: 10.1007/s00701-008-1591-0. Epub 2008 May 30.
Subdural haematomas can present with a wide variety of symptoms. An atypical presentation can be movement disorders. The key feature is that the history of onset is more rapid than with neurological conditions such as Parkinson's disease. The symptoms can also be an acute worsening of pre-existing disorder. The case discussed involved an 80 year old woman with bilateral choreathetoid movements attributed to a unilateral chronic subdural haematoma. The haematoma was surgically drained and the symptoms resolved. Sporadic reports of similar cases of movement disorders associated with subdural haematomas exist in the literature, but rarely do unilateral haematomas present with bilateral symptoms. Pressure effects, neurotransmitter abnormality and ischaemia have been postulated as reasons for this type of presentation. Unexplained and sudden movement disorders might warrant imaging to rule out a subdural haematoma as the cause.
硬膜下血肿可表现出多种多样的症状。非典型表现可能为运动障碍。关键特征是起病病史比帕金森病等神经系统疾病更为迅速。症状也可能是原有疾病的急性加重。所讨论的病例涉及一名80岁女性,其双侧舞蹈手足徐动症归因于单侧慢性硬膜下血肿。血肿通过手术引流,症状得以缓解。文献中存在与硬膜下血肿相关的类似运动障碍病例的零星报道,但单侧血肿很少出现双侧症状。压力效应、神经递质异常和缺血被认为是这种表现类型的原因。不明原因的突发运动障碍可能需要进行影像学检查以排除硬膜下血肿作为病因。