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自发性颈段硬膜外血肿致布朗-色夸综合征:病例报告

Spontaneous cervical epidural hematoma causing Brown-Sequard syndrome: case report.

作者信息

Ofluoğlu Ender, Ozdemir Ayşegül, Toplamaoğlu Halil, Sofuoğlu Erhan

机构信息

Bakirkoy Hospital for Psychiatric and Neurological Diseases, Neurosurgery Department, Istanbul, Turkey.

出版信息

Turk Neurosurg. 2009 Jan;19(1):99-102.

Abstract

OBJECTIVE

Spontaneously occurring epidural hematoma without any identified etiology is a rare phenomenon. These are often neurosurgical emergencies; therefore, prompt diagnosis and treatment are paramount. Because of the rarity of this condition, we illustrated its presentation, evaluation and management in this recent case.

CASE

A 63-year-old male presented to our emergency room with right-sided hemiparesis and contralateral hypoesthesia, consistent with a C5 Brown-Sequard syndrome. An initial evaluation for cerebral infarction was unremarkable, including a negative brain computerized tomography imaging. Cervical magnetic resonance imaging (MRI) revealed a cervical epidural hematoma. The patient underwent emergent laminectomy for decompression and evacuation of the hematoma within 24 hours of presentation to the emergency room. The patient's symptoms improved remarkably after surgery and a 4th-month follow-up MRI evaluation was normal.

CONCLUSION

This report highlights the various presentations, evaluation, and management options for this rare diagnosis. It emphasizes the necessity of prompt diagnosis for possible emergent intervention.

摘要

目的

无明确病因的自发性硬膜外血肿是一种罕见现象。这些情况往往是神经外科急症;因此,迅速诊断和治疗至关重要。由于这种病症罕见,我们在此近期病例中阐述了其表现、评估及处理方法。

病例

一名63岁男性因右侧偏瘫和对侧感觉减退就诊于我们的急诊室,符合C5脊髓半切综合征。对脑梗死的初步评估未见异常,包括脑部计算机断层扫描成像结果为阴性。颈椎磁共振成像(MRI)显示颈椎硬膜外血肿。患者在就诊于急诊室后24小时内接受了急诊椎板切除术以减压和清除血肿。术后患者症状显著改善,术后4个月的MRI随访评估结果正常。

结论

本报告突出了这种罕见诊断的各种表现、评估及处理选择。强调了迅速诊断以便进行可能的紧急干预的必要性。

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