Panciani Pier Paolo, Cornali Claudio, Agnoletti Alessandro, Esposito Giacomo, Ronchetti Gabriele, Fontanella Marco
Department of Neuroscience, Division of Neurosurgery, University of Brescia, Piazza Spedali Civili, 25123 Brescia, Italy ; Department of Neuroscience, Division of Neurosurgery, University of Torino, 10126 Torino, Italy.
Case Rep Neurol Med. 2013;2013:310854. doi: 10.1155/2013/310854. Epub 2013 Jan 13.
Spinal chronic subdural hematoma (SCSH) is a rare pathology usually associated with trauma or hematological alterations or is due to iatrogenic causes; rarely SCSH can be spontaneous. We report a case of a 79-year-old female who underwent a surgical evacuation of a spontaneous SCSH one year after diagnosis. She presented with a severe paraparesis and showed a considerable improvement in sensory-motor performances after surgery. The treatment of spontaneous SCSH is not well defined and universally accepted. Early surgery is mandatory in cases presenting with severe deficits. To the best of our knowledge, this is the first case showing a good outcome in a case of SCSH following a delayed surgery. In our opinion, an aggressive approach should be considered as a viable option in cases of spontaneous SCSH even after a lasting spinal cord compression.
脊髓慢性硬膜下血肿(SCSH)是一种罕见的病理情况,通常与创伤、血液学改变相关或由医源性原因引起;很少有SCSH是自发的。我们报告一例79岁女性病例,其在诊断后一年接受了自发性SCSH的手术清除。她表现为严重的双下肢轻瘫,术后感觉运动功能有显著改善。自发性SCSH的治疗尚无明确且被普遍接受的方案。对于出现严重功能缺损的病例,早期手术是必要的。据我们所知,这是首例在延迟手术后SCSH病例取得良好预后的情况。我们认为,即使在脊髓长期受压的自发性SCSH病例中,积极的治疗方法也应被视为一种可行的选择。