Page R D, Lye R H
University Department of Neurosurgery, Manchester Royal Infirmary, England.
Arch Emerg Med. 1989 Sep;6(3):225-9. doi: 10.1136/emj.6.3.225.
The authors describe the case history of a patient who was stabbed in the back of his neck with a knife and who later presented with a Brown-Séquard syndrome attributable to cervical spinal cord damage. Myelography and CT revealed a compressive extradural lesion shown at exploratory operation to be a loculus of cerebrospinal fluid (CSF). The loculus had formed as a consequence of leakage of CSF through a dural tear caused by the knife. Evacuation of this loculus resulted in some neurological improvement. The necessity of obtaining a clear history and of performing a thorough clinical examination is explained. The need to admit patients in whom stab wounds of the neck have transgressed subcutaneous fat is reiterated. Early referral to a neurosurgeon is advised for those patients with neurological deficits.
作者描述了一名患者的病史，该患者颈部后侧被刀刺伤，随后出现了由颈脊髓损伤引起的布朗-塞卡尔综合征。脊髓造影和CT显示硬膜外有一个压迫性病变，在探查手术中发现是一个脑脊液（CSF）腔隙。该腔隙是由于脑脊液通过刀造成的硬脑膜撕裂处漏出而形成的。清除这个腔隙后神经功能有了一些改善。文中解释了获取清晰病史和进行全面临床检查的必要性。再次强调了对于颈部刺伤已穿透皮下脂肪的患者需要收治入院。建议对有神经功能缺损的患者尽早转诊给神经外科医生。
