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[菜刀所致脊髓刺伤:1例报告]

[Stab wounds of the spinal cord by a kitchen knife: report of a case].

作者信息

Takahashi I, Iwasaki Y, Abumiya T, Imamura H, Houkin K, Saitoh H, Katoh T, Nomura M, Akino M, Isu T

机构信息

Sapporo Azabu Neurosurgical Hospital.

出版信息

No Shinkei Geka. 1991 Mar;19(3):255-8.

PMID:2038415
Abstract

A case of spinal cord injury due to stab wounds by a kitchen knife is presented. A 41-year-old male was hospitalized because of spinal cord injury resulting from stab wounds inflicted with a kitchen knife in the posterior cervical area. Neurological examination on admission showed paraplegia, disappearance of deep tendon reflex in both lower extremities, sensory disturbance below T1 level, left Horner's syndrome and urinary disturbance. In addition to these symptoms cerebrospinal fluid was leaking from the wounds. An emergency operation was performed. After laminectomy of C7 and T1, we found that the spinal cord was almost completely split at C7/T1 level. Dural plasty was performed. Neurologically, sensory disturbance was slightly improved at 4 months after the injury. Initial MRI (TR: 200 msec, TE: 20 msec) revealed high intensity at C7/T1 level which was damaged by the kitchen knife. MRI 5 months after the injury revealed low intensity on T1 weighted imaged, high intensity on T2 and proton weighted image. The occurrence of the spinal cord injury due to stab wounds by a kitchen knife is very rare in Japan. MRI is useful in the diagnosis of stab wounds of the spinal cord.

摘要

本文报告一例因菜刀刺伤导致脊髓损伤的病例。一名41岁男性因后颈部被菜刀刺伤导致脊髓损伤而住院。入院时神经学检查显示双下肢截瘫、双下肢深腱反射消失、T1水平以下感觉障碍、左侧霍纳综合征及排尿障碍。除上述症状外,伤口处有脑脊液漏出。遂行急诊手术。在切除C7和T1椎板后,发现脊髓在C7/T1水平几乎完全断裂。进行了硬脑膜成形术。神经学方面,损伤后4个月感觉障碍稍有改善。最初的MRI(TR:200毫秒,TE:20毫秒)显示C7/T1水平因菜刀损伤而呈高信号。损伤后5个月的MRI显示T1加权像呈低信号,T2加权像和质子加权像呈高信号。在日本,因菜刀刺伤导致脊髓损伤的情况非常罕见。MRI对脊髓刺伤的诊断很有用。

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