Oktem Nurgül Balci, Tari Rabia, Kotil Kadir, Bilge Turgay
M.H. Haseki Educational and Research Hospital, Department of Neurosurgery, Istanbul, Turkey.
Turk Neurosurg. 2012;22(1):99-101. doi: 10.5137/1019-5149.JTN.2962-10.1.
A 74-year-old woman, taking anticoagulant therapy for chronic heart failure, presented to our emergency room with left dorsiflexion weakness 8 hours from after multitrauma. A detailed neurological examination revealed only 0/5 strength in the left foot dorsiflexion without any upper motor neuron signs. While there was no spinal cord pathology detected, cranial computed tomography demonstrated a lesion in the right parasagittal localization consistent with hemorrhagic contusion. Clinical follow-ups showed an improvement in neurological findings with muscle power of 3/5 in day 5 and 5/5 in day 45 of admission. The parasagittal region has a foot localization in the homonculus and lesions in this area can rarely present with the foot drop sign. Thus, parasagittal region lesions should always be kept in mind in foot drop cases.
一名74岁女性，因慢性心力衰竭接受抗凝治疗，在多处创伤后8小时因左足背屈无力被送至我院急诊室。详细的神经系统检查显示左脚背屈肌力仅为0/5，无任何上运动神经元体征。虽然未检测到脊髓病变，但头颅计算机断层扫描显示右矢状旁区域有一个与出血性挫伤相符的病变。临床随访显示，入院第5天神经学检查结果有所改善，肌力为3/5，第45天为5/5。在大脑皮质运动区的小人像中，矢状旁区域代表足部，该区域的病变很少表现为足下垂体征。因此，在足下垂病例中应始终考虑矢状旁区域病变。
