Soda Takao, Shimizu Isao, Takagaki Masatoshi, Yamada Kimito, Dehara Makoto, Teramoto Yoshifumi, Moriuchi Shusuke
Department of Neurology, Rinku General Medical Center, Japan.
Brain Nerve. 2011 Oct;63(10):1125-9.
A 35-year-old woman was admitted to our hospital with acute onset paraparesis, sensory disturbance in her lower body, and urinary disturbance. She had given birth by normal vaginal delivery 6 days before the onset of these symptoms. On admission, paresis of her left leg was more severe than that of her right leg. Deep tendon reflexes of her lower limbs were hyperactive, and bilateral Babinski reflexes were observed. The patient's thermal and pain sensations below the lumbus were impaired. She lost bladder-filling sensation and bladder control. She showed an anterior spinal artery syndrome. Blood analysis revealed thrombocytosis and high fibrolytic activity. MRI of the brain and spinal cord did not show any lesions. Cerebrospinal fluid measurements showed that parameters were within the normal range and that the protein levels were not increased. We considered that a spinal cord infarction had occurred. After administration of antithrombotic agents and methylpredonisolone, her symptoms gradually improved. The coagulation disorders during the peripartum period were assumed to be a cause of anterior spinal artery syndrome in this case. It is very rare for perinatal women to have a spinal cord infarction. Only 3 cases of spinal cord infarction during the perinatal period have been reported thus far.
一名35岁女性因急性发作的双下肢轻瘫、下半身感觉障碍及排尿障碍入院。这些症状出现前6天，她经阴道顺产。入院时，其左腿轻瘫比右腿更严重。下肢深腱反射亢进，双侧巴氏征阳性。患者腰部以下温度觉和痛觉受损。她失去膀胱充盈感及膀胱控制能力。她表现为脊髓前动脉综合征。血液分析显示血小板增多及高纤溶活性。脑部和脊髓的MRI未显示任何病变。脑脊液检测显示各项参数在正常范围内且蛋白水平未升高。我们认为发生了脊髓梗死。给予抗血栓药物和甲基泼尼松龙后，她的症状逐渐改善。本例中，围产期凝血障碍被认为是脊髓前动脉综合征的一个病因。围产期女性发生脊髓梗死非常罕见。迄今为止，仅报道过3例围产期脊髓梗死病例。
