Kim Hyeun Sung, Adsul Nitin, Ju Yoon Seok, Kim Ki Joon, Choi Sung Ho, Kim Jeong Hoon, Chung Sung Kyun, Choi Jeong-Hoon, Jang Jee-Soo, Jang Il-Tae, Oh Seong-Hoon, Park Jae Eun, Lee Sol
Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, Korea.
Department of Neurosurgery, Nanoori Hospital, Seoul, Korea.
Surg Neurol Int. 2017 Sep 26;8:231. doi: 10.4103/sni.sni_262_17. eCollection 2017.
Chronic spinal subdural hematomas are extremely rare with only 28 cases reported in the literature. Nevertheless, they should be considered among the differential diagnoses for spinal intradural/extramedullary lesions.
A 65-year-old male presented with progressive back pain and right S1 radiculopathy. Magnetic resonance imaging scan revealed a right-sided posterolateral intradural/extramedullary lesion at the L5-S1 level. It was hyperintense on T1 and hypointense on T2-weighted images; on the short TI inversion recovery sequence it was hyperintense. The lesion was excised through a right L5 hemilaminectomy, and the patient was neurologically intact postoperatively. Histopathology revealed a chronic subdural hematoma.
Chronic spinal subdural hematoma can mimic intradural extramedullary spinal tumors even in the absence of trauma and/or coagulopathies.
慢性脊髓硬膜下血肿极为罕见，文献中仅报道过28例。然而，在脊髓硬膜内/髓外病变的鉴别诊断中应考虑到该病。
一名65岁男性，出现进行性背痛和右侧S1神经根病。磁共振成像扫描显示L5-S1水平右侧后外侧硬膜内/髓外病变。在T1加权像上呈高信号，在T2加权像上呈低信号；在短TI反转恢复序列上呈高信号。通过右侧L5半椎板切除术切除病变，术后患者神经功能完好。组织病理学检查显示为慢性硬膜下血肿。
即使没有创伤和/或凝血功能障碍，慢性脊髓硬膜下血肿也可能酷似硬膜内髓外脊髓肿瘤。
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