Lim Jae Joon, Yoon Soo Han, Cho Ki Hong, Kim Sang Hyun
Department of Neurosurgery, Ajou University, School of Medicine, Suwon, Korea.
J Korean Neurosurg Soc. 2008 Aug;44(2):84-7. doi: 10.3340/jkns.2008.44.2.84. Epub 2008 Aug 30.
Spontaneous spinal epidural hematoma (SSEH) is rare in children, especially in infants, in whom only 12 cases have been reported. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed. We report herein a case of SSEH in a 20-month-old girl who initially presented with neck pain, and developed lower extremity motor weakness and symptoms of neurogenic bladder 2 weeks prior to admission. The magnetic resonance imaging showed an epidural mass lesion extending from C7 to T4, and the spinal cord was severely compressed by the mass. After emergency decompressive surgery the neurologic function was improved immediately. Two months after surgery, the neurological status was normal with achievement of spontaneous voiding. We suggest that surgical intervention can provide excellent prognosis in case of SSEH in infants, even if surgery delayed.
自发性脊髓硬膜外血肿(SSEH)在儿童中较为罕见,尤其是在婴儿中,仅有12例相关报道。由于儿童出现症状的非特异性,诊断可能会延迟。我们在此报告一例20个月大女童的SSEH病例,该患儿最初表现为颈部疼痛,入院前2周出现下肢运动无力和神经源性膀胱症状。磁共振成像显示硬膜外肿块病变从C7延伸至T4,脊髓被肿块严重压迫。紧急减压手术后,神经功能立即得到改善。术后两个月,神经状态正常,实现了自主排尿。我们认为,即使手术延迟,对于婴儿SSEH病例,手术干预仍可提供良好的预后。