Gopalakrishnan Chittur Viswanathan, Vikas Vazhayil, Nair Suresh
Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Asian Spine J. 2011 Mar;5(1):64-7. doi: 10.4184/asj.2011.5.1.64. Epub 2011 Mar 2.
A 14-year-old girl presented with progressive paraparesis and paresthesia of one-year duration. Magnetic resonance imaging revealed a T6 vertebral hemangioma with epidural compression on the spinal cord. Following angiography and embolization, she underwent dorsal laminectomy and excision of the soft tissue component compressing the cord. In the postoperative period she had rapid worsening of lower limb power and imaging demonstrated an epidural haematoma at the operative site. The patient was taken up for urgent re-exploration and evacuation of haematoma. Postoperatively the patient complained of visual failure, headache and had multiple episodes of seizures. An magnetic resonance imaging brain showed characteristic features of posterior reversible encephalopathy syndrome (PRES) and the patient improved gradually after control of hypertension. This is the first documented case of PRES following spinal cord compression in a patient without any known risk factors. We postulate the possible mechanism involved in its pathogenesis.
一名14岁女孩出现进行性双下肢轻瘫和感觉异常，持续1年。磁共振成像显示T6椎体血管瘤伴脊髓硬膜外压迫。血管造影和栓塞后，她接受了后路椎板切除术和压迫脊髓的软组织成分切除术。术后她下肢力量迅速恶化，影像学显示手术部位硬膜外血肿。患者接受了紧急再次探查和血肿清除术。术后患者出现视力减退、头痛，并多次癫痫发作。脑部磁共振成像显示了后部可逆性脑病综合征（PRES）的特征性表现，控制高血压后患者逐渐好转。这是首例在无任何已知危险因素的患者中脊髓受压后发生PRES的记录病例。我们推测了其发病机制中可能涉及的机制。
