O'Phalen Kristine H, Bunney E Bradshaw, Kuluz John W
Department of Neurology, University of Miami, Miami, FL, USA.
Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Neurocrit Care. 2015 Dec;23 Suppl 2:S129-35. doi: 10.1007/s12028-015-0166-1.
There are many causes of acute myelopathy including multiple sclerosis, systemic disease (SD), and acute spinal cord compression (SCC). SCC should be among the first potential causes considered given the significant permanent loss of neurologic function commonly associated with SCC. This impairment can occur over a short period of time, and may be avoided through rapid and acute surgical intervention. Patients with SCC typically present with a combination of motor and sensory dysfunction that has a distribution referable to a spinal level. Bowel and bladder dysfunction and neck or back pain may also be part of the clinical presentation, but are not uniformly present. Because interventions are critically time-sensitive, the recognition and treatment of SCC was chosen as an ENLS protocol.
急性脊髓病有多种病因,包括多发性硬化症、全身性疾病(SD)和急性脊髓压迫症(SCC)。鉴于SCC通常会导致严重的永久性神经功能丧失,它应是首先考虑的潜在病因之一。这种损害可能在短时间内发生,通过快速的急性手术干预或许可以避免。SCC患者通常表现为运动和感觉功能障碍的组合,其分布与脊髓节段相关。肠道和膀胱功能障碍以及颈部或背部疼痛也可能是临床表现的一部分,但并非都会出现。由于干预措施对时间极为敏感,因此将SCC的识别和治疗选为急诊神经生命支持(ENLS)方案。