Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore.
Jpn J Radiol. 2012 Jun;30(5):450-2. doi: 10.1007/s11604-012-0064-9. Epub 2012 Mar 2.
Hematomyelia is rare, and usually related to major trauma. Non-traumatic causes are much rarer and include underlying vascular malformations and cord tumors. We present the case of a previously well 44-year-old woman who developed severe acute neck pain and right-sided motor deficit after a session of traditional Chinese massage that entailed minimal neck manipulation. Emergent MRI confirmed hematomyelia of the right cervical hemicord, notably without associated bony or ligamentous injury. Follow-up spinal angiography and MRIs revealed no underlying vascular malformation or tumor. We highlight this case as there has been no reported case of hematomyelia occurring after mild trauma, although two cases of idiopathic hematomyelia have been reported. Though exceedingly rare, hematomyelia should be considered in the list of differential diagnoses in any case of neck pain and motor deficit after seemingly trivial injury.
脊髓血肿较为罕见,通常与严重外伤相关。非外伤性病因则更为少见,包括脊髓血管畸形和脊髓肿瘤。我们报告 1 例既往健康的 44 岁女性,在接受传统中医推拿后突发严重急性颈痛和右侧运动功能障碍,推拿过程中仅行轻微颈部操作。紧急 MRI 检查证实右侧颈髓半切出现脊髓血肿,且无相关骨或韧带损伤。进一步的脊髓血管造影和 MRI 检查未发现潜在的血管畸形或肿瘤。我们强调该病例,因为尽管曾有 2 例特发性脊髓血肿的报告,但目前尚无轻度外伤后发生脊髓血肿的报道。尽管极为罕见,但对于任何看似轻微损伤后出现颈痛和运动功能障碍的患者,都应考虑脊髓血肿的鉴别诊断。