Kim Jin Kyu, Kim Tae Hong, Park Sang Keun, Hwang Yong Soon, Shin Hyung Shik, Shin Jun Jae
Department of Neurosurgery, Sanggye-Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Korean J Spine. 2013 Sep;10(3):170-3. doi: 10.14245/kjs.2013.10.3.170. Epub 2013 Sep 30.
Spontaneous cervical epidural hematoma (SCEDH) is a rare disease, but can cause severe neurologic impairment. We report a case of a 68-year-old female who presented with sudden onset, posterior neck pain, right shoulder pain, and progressive right hemiparesis mimicking stroke with no trauma history. Initial brain CT and diffusion MRI performed to rule out brain lesion did not show any positive findings. Laboratory examination presented only severe thrombocytopenia (45,000/mm(3)). Subsequent cervical MRI revealed a cervical epidural mass lesion. We confirmed that it was pure hematoma through C5 unilateral total laminectomy and C6 partial hemilaminectomy. She achieved complete neurologic recovery with active rehabilitation. Early surgical decompression for SCEDH with neurologic impairment should be recommended for better outcome.
自发性颈段硬膜外血肿(SCEDH)是一种罕见疾病,但可导致严重神经功能损害。我们报告一例68岁女性,突发后颈部疼痛、右肩部疼痛,并逐渐出现右半身轻瘫,类似中风,无外伤史。最初为排除脑部病变而行的脑部CT和弥散MRI未显示任何阳性结果。实验室检查仅显示严重血小板减少(45,000/mm³)。随后的颈椎MRI显示颈段硬膜外有肿块病变。通过C5单侧全椎板切除术和C6部分半椎板切除术,我们证实其为单纯血肿。她通过积极康复实现了神经功能完全恢复。对于有神经功能损害的SCEDH,应建议早期进行手术减压以获得更好的预后。