Demirkale İsmail, De Iure Federico, Terzi Silvia, Gasbarrini Alessandro
Department of Orthopedics and Traumatology, Keçiören Training and Research Hospital, 06280 Keçiören, Ankara, Turkey.
Eklem Hastalik Cerrahisi. 2016;27(1):46-50. doi: 10.5606/ehc.2016.09.
Type and timing of treatment for symptomatic hemangiomas in pregnant females are challenging due to fetus survival and conflicts in neurological recovery. In this article, we report a 40-year-old female patient at pregnancy week 23 with a complicated hemangioma at T1 level. Physical examination revealed an incomplete spastic paraplegia. Patient did not accept any surgery due to child's death risk. Patient was started corticoid treatment and no more weight bearing was allowed. At the 28th week of pregnancy, the patient underwent cesarean section immediately followed by selective arterial embolization, decompression, fixation, and radiotherapy. At two-year follow-up, the patient was pain free, without any signs of local recurrence and with complete neurological recovery. A multidisciplinary approach is mandatory to save the life of the fetus without damaging the spinal cord functions of the mother.
由于胎儿存活以及神经功能恢复方面的矛盾,孕期有症状血管瘤的治疗类型和时机颇具挑战性。在本文中,我们报告了一名23孕周的40岁女性患者,其T1水平存在复杂血管瘤。体格检查显示不完全性痉挛性截瘫。由于存在胎儿死亡风险,患者未接受任何手术。患者开始接受皮质类固醇治疗,且不允许再负重。在怀孕第28周时,患者立即接受剖宫产,随后进行选择性动脉栓塞、减压、固定和放疗。在两年的随访中,患者无痛,无任何局部复发迹象,神经功能完全恢复。必须采取多学科方法,在不损害母亲脊髓功能的情况下挽救胎儿生命。