原位肝移植后自发性脊髓硬膜外血肿及脊髓梗死：病例报告及文献复习
Spontaneous spinal epidural hematoma and spinal cord infarction following orthotopic liver transplantation: Case report and review of the literature.
作者信息
Buchanan Colin C, Lu Daniel C, Buchanan Corinne, Tran Tram T
机构信息
Department of Neurosurgery, Cedars-Sinai Medical Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
出版信息
Surg Neurol Int. 2013 Oct 29;4(Suppl 5):S359-61. doi: 10.4103/2152-7806.120775. eCollection 2013.
BACKGROUND
Spinal epidural hematomas are rare conditions. Although the exact cause remains unknown in up to 40% of cases, anticoagulation therapy, neoplasm, thrombolytic therapy, internal jugular vein thrombosis, and prolonged Valsalva maneuvers associated with pregnancy may be contributing factors. The source of bleeding appears to be the dorsal internal vertebral venous plexus (IVVP).
CASE DESCRIPTION
A 65-year-old female patient with hepatitis C-related cirrhosis underwent orthotopic liver transplantation (OLT). The patient developed SSEH due to congestion of the IVVP in the peri-transplant period. Concurrent spinal cord infarction occurred, likely secondary to hypoperfusion during a cardiac arrest.
CONCLUSION
This case study should increase awareness of SSEH as a complication of OLT.
背景
脊髓硬膜外血肿是罕见病症。尽管高达40%的病例确切病因仍不明，但抗凝治疗、肿瘤、溶栓治疗、颈内静脉血栓形成以及与妊娠相关的长时间瓦尔萨尔瓦动作可能是促成因素。出血来源似乎是椎体内侧静脉丛（IVVP）。
病例描述
一名65岁丙型肝炎相关肝硬化女性患者接受了原位肝移植（OLT）。该患者在移植围手术期因IVVP充血而发生脊髓硬膜外血肿（SSEH）。同时发生了脊髓梗死，可能继发于心搏骤停期间的灌注不足。
结论
本病例研究应提高对OLT并发症SSEH的认识。
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