Kunizawa Ai, Fujioka Masayuki, Suzuki Satoshi, Ryu Takashi, Asai Akio, Kawamoto Keiji, Kitazawa Yasuhide
Department of Critical Care Medicine, Kansai Medical University, Hirakata-city, Osaka, Japan.
J Neurosurg Spine. 2009 Jun;10(6):574-7. doi: 10.3171/2009.2.SPINE08342.
Spontaneous spinal epidural hematoma (SSEH) is rare. Its etiology remains controversial; however, spinal venous wall susceptibility to intravenous pressure change and the resultant venous rupture seem to be involved. The authors report a case of SSEH dorsal to the spine producing acute anterior spinal cord syndrome. A posterior SSEH between the C-3 and T-5 levels caused progressive tetraparesis and the disappearance of superficial body sensation below the level of C-8, although deep sensation remained completely intact. This neurological false localizing sign seems to have resulted from counterforce by preexisting asymptomatic cervical intervertebral disc herniation at the C6-7 levels inducing direct pressure on the anterior spinal cord. This case is the first reported instance of posterior cervical SSEH manifesting acute anterior spinal cord syndrome as its false localizing sign.
自发性脊髓硬膜外血肿（SSEH）较为罕见。其病因仍存在争议；然而，脊髓静脉壁对静脉压力变化的易感性以及由此导致的静脉破裂似乎与之相关。作者报告了一例发生在脊柱后方的SSEH导致急性脊髓前综合征的病例。C3至T5水平之间的后方SSEH导致进行性四肢轻瘫，C8水平以下的体表浅感觉消失，尽管深感觉完全正常。这种神经学上的假定位体征似乎是由C6 - 7水平预先存在的无症状颈椎间盘突出症产生的反作用力导致对脊髓前部直接压迫所致。该病例是首次报道的以急性脊髓前综合征作为假定位体征的颈后部SSEH。
