Division of Neurosurgery, Department of Surgery, Taichung Armed Forces General Hospital, Taiwan.
Kaohsiung J Med Sci. 2011 Oct;27(10):473-6. doi: 10.1016/j.kjms.2011.06.009. Epub 2011 Jul 28.
Traumatic spinal subdural hematoma is rare and its mechanism remains unclear. This intervention describes a patient with mental retardation who was suffering from back pain and progressive weakness of the lower limbs following a traffic accident. Magnetic resonance imaging of the spine revealed a lumbar subdural lesion. Hematoma was identified in the spinal subdural space during an operation. The muscle power of both lower limbs recovered to normal after surgery. The isolated traumatic spinal subdural hematoma was not associated with intracranial subdural hemorrhage. A spinal subdural hematoma should be considered in the differential diagnosis of spinal cord compression, especially for patients who have sustained spinal trauma. Emergency surgical decompression is usually the optimal treatment for a spinal subdural hematoma with acute deterioration and severe neurological deficits.
外伤性脊柱硬脑膜下血肿较为罕见，其发病机制尚不清楚。本介入病例描述了 1 例智力障碍患者，因交通事故后出现背痛和下肢进行性无力。脊柱磁共振成像显示腰骶部硬脑膜下病变。术中发现硬脑膜下椎管内血肿。术后双下肢肌力恢复正常。孤立性外伤性脊柱硬脑膜下血肿与颅内硬脑膜下血肿无关。对于有脊柱创伤的患者，出现脊髓压迫时应考虑到脊柱硬脑膜下血肿的可能。对于急性恶化和严重神经功能缺损的脊柱硬脑膜下血肿，通常采用紧急手术减压治疗。
