Hyun Seung-Jae, Hwang Sung-Nam, Nam Taek-Kyun, Park Seung-Won, Byun Jun-Soo
Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, ROK.
Neurol Med Chir (Tokyo). 2011;51(2):119-22. doi: 10.2176/nmc.51.119.
A 44-year-old woman presented with severe headache, drowsy mentality, and right hemiparesis. Brain computed tomography and magnetic resonance angiography revealed non-aneurysmal subarachnoid hemorrhage (SAH). Thoraco-abdominal and pelvic computed tomography angiography showed multiple steno-occlusive lesions involving the aorta and its large branches suggesting Takayasu's arteritis. Spine magnetic resonance imaging was taken because of prominent right hand muscle atrophy on the 14th hospital day, which showed subacute stage of hematomyelia in the cervical cord and conus medullaris. Aneurysmal or non-aneurysmal SAH is rare in patients with Takayasu's arteritis but SAH with coincidental hematomyelia is even more unusual. This case emphasizes the rarity of the coincidental spinal hematomyelia and its importance in the differential diagnosis.
一名44岁女性出现严重头痛、嗜睡及右侧偏瘫。脑部计算机断层扫描和磁共振血管造影显示为非动脉瘤性蛛网膜下腔出血（SAH）。胸腹部及盆腔计算机断层扫描血管造影显示主动脉及其大分支存在多处狭窄闭塞性病变，提示为高安动脉炎。患者住院第14天时，因右手肌肉明显萎缩进行了脊柱磁共振成像检查，结果显示颈髓和脊髓圆锥处于脊髓血肿亚急性期。高安动脉炎患者中动脉瘤性或非动脉瘤性SAH均较为罕见，但合并脊髓血肿的SAH更为少见。该病例强调了合并脊髓血肿的罕见性及其在鉴别诊断中的重要性。
