Cha Kyung Han, Cho Tack Geun, Kim Chang Hyun, Lee Ho Kook, Moon Jae Gon
Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
Korean J Spine. 2013 Sep;10(3):203-5. doi: 10.14245/kjs.2013.10.3.203. Epub 2013 Sep 30.
A 45-year-old female patient visited the hospital complaining of severe sudden headache and posterior neck pain. The patient did not have any traumatic history or abnormal neurologic finding. The patient had sudden quadriplegia and sensory loss. Cervical spine MRI scan was taken, and the compatible findings to acute epidural hematoma were shown. The emergency operation was performed. After the operation, the patient recovered all motor and senses. As there was CSF leakage in the postoperative wound, this was confirmed by cervical spinal computed tomography (CT). Then lumbar drainage was thus performed. The opening pressure upon lumbar puncture was not measured as it was very low. As a result of continous CSF leakage, dural repair was performed. After the operation, the patient had been discharged without neurologic deficits. In this case, it is sensible to suspect intracranial hypotension as a possible cause of spinal EDH.
一名45岁女性患者因突发严重头痛和后颈部疼痛前来就诊。该患者无任何外伤史或神经系统异常表现。患者突然出现四肢瘫痪和感觉丧失。进行了颈椎磁共振成像（MRI）扫描，显示出与急性硬膜外血肿相符的表现。遂进行了急诊手术。术后，患者恢复了所有运动和感觉功能。由于术后伤口出现脑脊液漏，经颈椎计算机断层扫描（CT）证实。随后进行了腰椎引流。因腰椎穿刺时开放压力极低，未进行测量。由于脑脊液持续漏出，进行了硬脑膜修补术。术后，患者出院时无神经功能缺损。在这种情况下，怀疑颅内低压是脊髓硬膜外血肿的可能原因是合理的。
