Lo Chung-Chen, Chen Jun-Yih, Lo Yuk-Keung, Lai Ping-Hong, Lin Yuh-Te
Section of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Acta Neurol Taiwan. 2012 Mar;21(1):31-4.
To emphasize the importance of early recognition and emergent surgery for spontaneous spinal epidural hematoma (SSEH).
A 61-year-old female presented with sudden onset of severe neck and back pain after finishing worshiping Buddha followed by quadriparesis, sensory deficits below C4 level and sphincter dysfunction. MR imaging demonstrated acute extensive epidural hematoma of cervico-thoracic spinal segments (C2-T7). Idiopathic SSEH was diagnosed and emergent decompressive laminectomy with hematoma evacuation was performed within 12 hours of symptoms onset. Good functional and neurological outcomes were obtained.
SSEH is a rare but disabling or even fatal entity. Early diagnosis and prompt surgery improve the neurological and functional outcome but still remain a clinical challenge. Relevant physicians should pay attention to the typical symptoms of the rare entity and SSEH should be one of differential diagnoses.
强调早期识别和急诊手术治疗自发性脊髓硬膜外血肿（SSEH）的重要性。
一名61岁女性在拜佛结束后突然出现严重的颈部和背部疼痛，随后出现四肢瘫、C4水平以下感觉障碍和括约肌功能障碍。磁共振成像显示颈胸段脊髓（C2-T7）急性广泛硬膜外血肿。诊断为特发性SSEH，并在症状出现后12小时内进行了急诊减压椎板切除术并清除血肿。获得了良好的功能和神经学结果。
SSEH是一种罕见但致残甚至致命的疾病。早期诊断和及时手术可改善神经学和功能结果，但仍然是一项临床挑战。相关医生应注意这种罕见疾病的典型症状，SSEH应作为鉴别诊断之一。
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