一名患有脊髓硬膜内髓外肿瘤的患者在脊髓硬膜外麻醉后出现神经系统并发症。
Neurologic complication following spinal epidural anesthesia in a patient with spinal intradural extramedullary tumor.
作者信息
Kim Sung Hoon, Song Geun Sung, Son Dong Wuk, Lee Sang Won
机构信息
Department of Neurosurgery, School of Medicine, Yangsan Pusan National University, Yangsan, Korea.
出版信息
J Korean Neurosurg Soc. 2010 Dec;48(6):544-6. doi: 10.3340/jkns.2010.48.6.544. Epub 2010 Dec 31.
Abstract
Paraplegia following spinal epidural anesthesia is extremely rare. Various lesions for neurologic complications have been documented in the literature. We report a 66-year-old female who developed paraplegia after left knee surgery for osteoarthritis under spinal epidural anesthesia. In the recovery room, paraplegia and numbness below T4 vertebra was checked. A magnetic resonance image (MRI) scan showed a spinal thoracic intradural extramedullary (IDEM) tumor. After extirpation of the tumor, the motor weakness improved to the grade of 3/5. If a neurologic deficit following spinal epidural anesthesia does not resolve, a MRI should be performed without delay to accurately diagnose the cause of the deficit and optimal treatment should be rendered for the causative lesion.
摘要
脊髓硬膜外麻醉后发生截瘫极为罕见。文献中已记载了各种神经系统并发症的病变情况。我们报告一名66岁女性，她在脊髓硬膜外麻醉下接受左膝骨关节炎手术后出现了截瘫。在恢复室检查发现T4椎体以下截瘫和麻木。磁共振成像（MRI）扫描显示胸段脊髓硬膜内髓外（IDEM）肿瘤。肿瘤切除后，运动无力改善至3/5级。如果脊髓硬膜外麻醉后出现神经功能缺损未缓解，应立即进行MRI检查以准确诊断缺损原因，并对致病病变进行最佳治疗。
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