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自发性颈段硬膜外血肿继发的布朗-色夸综合征——一种罕见病症

Brown Sequard Syndrome Secondary to a Spontaneous Cervical Epidural Hematoma - A Rare Entity.

作者信息

Roy Shuvendu Prosad, Agrawal Nikunj

机构信息

Department of Orthopaedics Sir Ganga Ram Hospital New Delhi, India.

出版信息

J Orthop Case Rep. 2012 Oct-Dec;2(4):23-5.

Abstract

INTRODUCTION

Brown Sequard syndrome resulting from compression due to an epidural hematoma is a relatively rare occurrence, more so with a spontaneous history. We report one such case.

CASE REPORT

We present a 65yr old female presenting with hemiplegia with contralateral anesthesia. Magnetic resonance imaging showed a hematoma in the epidural space in the C3-C4 region. She underwent an open door laminoplasty for evacuation of the hematoma. Following surgery the patient responded rapidly and currently at 18 months follow up she is neurologically grade 5/5 with normal sensations.

CONCLUSIONS

In the emergency room when a patient is clinically diagnosed as a case of Brown Sequard syndrome it is important to ask for an MRI scan of the cervical spine. Hematoma in the cervical epidural space should be considered in the differential diagnosis of Brown Sequard syndrome especially in the elderly with history of doubtful trivial trauma.

摘要

引言

硬膜外血肿压迫导致的布朗 - 色夸综合征相对少见,自发形成的更为罕见。我们报告这样一例病例。

病例报告

我们介绍一位65岁女性,表现为偏瘫伴对侧感觉缺失。磁共振成像显示C3 - C4区域硬膜外间隙有血肿。她接受了开门式椎板成形术以清除血肿。术后患者恢复迅速,目前在18个月的随访中,其神经功能为5/5级,感觉正常。

结论

在急诊室,当临床诊断患者为布朗 - 色夸综合征时,进行颈椎磁共振成像扫描很重要。在布朗 - 色夸综合征的鉴别诊断中,应考虑颈椎硬膜外间隙血肿,尤其是对有可疑轻微外伤史的老年人。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe02/4722547/43f452db92c2/JOCR-2-23-g001.jpg

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