Abuzayed Bashar, Oğuzoğlu Söhret Ali, Dashti Reza, Ozyurt Emin
Istanbul University, Cerrahpaşa Medical Faculty, Neurosurgery Department, Istanbul, Turkey.
Turk Neurosurg. 2009 Apr;19(2):189-91.
A 22-year-old man with medical history of Hemophilia A was admitted with a 3- month history of low back pain radiating to the right leg. Neurological examination revealed no abnormalities. Spinal magnetic resonance imaging (MRI) with gadolinium enhancement revealed an intradural extramedullary mass at the level of L1 reported as an intradural tumor. The patient was operated after Factor VIII replacement. Intraoperatively, the lesion was found to be a pure subdural hematoma. The histopathological examination revealed pure chronic hematoma. Postoperatively the patient's complaints showed improvement and he was discharged with no complications. Although MRI is the gold standard of diagnosis for spinal intradural tumors, some mass lesions remain difficult to diagnose. Spinal chronic subdural hematoma should be considered in the differential diagnosis in these patients, especially in those with coagulopathies, even in the absence of a history of trauma.
一名有甲型血友病病史的22岁男性因腰痛3个月并向右下肢放射而入院。神经系统检查未发现异常。钆增强脊髓磁共振成像(MRI)显示L1水平有硬膜内髓外肿块,报告为硬膜内肿瘤。患者在补充凝血因子VIII后接受手术。术中发现病变为单纯硬膜下血肿。组织病理学检查显示为单纯慢性血肿。术后患者的症状有所改善,出院时无并发症。尽管MRI是脊髓硬膜内肿瘤诊断的金标准,但一些肿块病变仍难以诊断。在这些患者的鉴别诊断中应考虑脊髓慢性硬膜下血肿,尤其是有凝血功能障碍的患者,即使没有外伤史。