Mascarenhas Lino
Neurosurgery Service, São Marcos Hospital, Apartado 2242, Braga, Portugal.
Eur Spine J. 2009 Jul;18 Suppl 2(Suppl 2):217-9. doi: 10.1007/s00586-008-0849-9. Epub 2008 Dec 11.
A hypo-coagulated 58-year-old female complained of headaches right after being exposed to the first pressure waves generated during an exhibition of fireworks. The day after she presented with seizures and the CT scan showed subdural hemorrhage over the left frontoparietal sulci. Eight hours after admission she disclosed left lower limb hypo-esthesia, i.e. a finding not attributable to the cranial hemorrhage. Four hours later sphincter dysfunction and paraparesis were also present with a left predominance. This was due to a T12-L1 subdural extramedullary hemorrhage. The patient was operated and showed a favorable outcome. Hypo-coagulated patients with cranial hemorrhage require prolonged surveillance and may harbor spinal hemorrhage as well. This rare combination can be unsuspected in view of the evident cranial event, and may cause severe neurological deficits if not detected.
一名58岁的凝血功能低下女性在烟花表演期间接触到产生的第一波压力波后立即抱怨头痛。第二天她出现癫痫发作，CT扫描显示左额顶沟处有硬膜下出血。入院8小时后，她出现左下肢感觉减退，即这一发现与颅内出血无关。4小时后，出现括约肌功能障碍和双侧轻瘫，以左侧为主。这是由于T12-L1硬膜下髓外出血所致。患者接受了手术，结果良好。患有颅内出血的凝血功能低下患者需要长期监测，并且可能也存在脊髓出血。鉴于明显的颅内事件，这种罕见的组合可能未被察觉，如果未被发现，可能会导致严重的神经功能缺损。
