后脊髓动脉综合征伴脊髓明显肿胀：一项临床病理研究
Posterior spinal artery syndrome showing marked swelling of the spinal cord: a clinico-pathological study.
作者信息
Matsubayashi Jun, Tsuchiya Kuniaki, Shimizu Soichiro, Kitagawa Naoyuki, Wakabayashi Yukari, Kuroda Masahiko, Sakurai Michio, Nagao Toshitaka
机构信息
Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.
出版信息
J Spinal Cord Med. 2013 Jan;36(1):31-5. doi: 10.1179/2045772312Y.0000000017.
OBJECTIVE
To describe a rare autopsy case of posterior spinal artery syndrome with marked swelling of the spinal cord, an unusually subacute onset and short clinical course.
METHODS
Case report.
FINDINGS
An 84-year-old Japanese woman presented with bilateral muscle weakness of the lower legs and sensory disturbance 1 week after head contusion. Neurological findings worsened gradually. She developed phrenic nerve paralysis and died of respiratory failure 6 weeks after the onset of neurological symptoms. On pathological examination, the spinal cord was markedly swollen in the cervical and upper thoracic segments. Microscopically, there was loss of myelin sheath in the bilateral posterior columns and neuronal loss of the posterior horns in all of the spinal segments. However, findings were unremarkable in the bilateral anterior columns and bilateral anterior horns in most of the spinal segments. Posterior spinal arteries had no stenosis, occlusion, or thrombosis. We considered that pathogenesis was infarction associated with head injury.
CONCLUSION
To our knowledge, this is the first report of a case of posterior spinal artery syndrome with a markedly swollen spinal cord and poor prognosis.
目的
描述一例罕见的伴有脊髓明显肿胀的脊髓后动脉综合征尸检病例，其起病异常亚急性且临床病程较短。
方法
病例报告。
结果
一名84岁日本女性在头部挫伤1周后出现双侧小腿肌肉无力和感觉障碍。神经学检查结果逐渐恶化。她出现膈神经麻痹，并在神经症状出现6周后死于呼吸衰竭。病理检查显示，颈段和上胸段脊髓明显肿胀。显微镜下，双侧后柱髓鞘脱失，所有脊髓节段后角神经元丢失。然而，大多数脊髓节段的双侧前柱和双侧前角未见明显异常。脊髓后动脉无狭窄、闭塞或血栓形成。我们认为其发病机制为与头部损伤相关的梗死。
结论
据我们所知，这是首例伴有脊髓明显肿胀且预后不良的脊髓后动脉综合征病例报告。
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