Garza-Mercado R
Department of Surgery, Facultad de Medicina, Universidad Autónoma de Nuevo Léon, Monterrey, Mexico.
Neurosurgery. 1989 Mar;24(3):410-4. doi: 10.1227/00006123-198903000-00018.
An example of a traumatic extradural hematoma of the cervical spine that occurred in a 32-year-old man who suffered from chronic ankylosing spondylitis is reported. Progressive sensory and motor deficit ensued some 3 hours after the patient fell from a standing position. The patient landed on his back, striking his head on the floor. After being helped up, he was able to walk unassisted to a nearby chair, where he sat down until his left lower extremity--and shortly afterwards, the right one--became numb and weak. On admission, the patient was found to have tetraparesis that was more pronounced in the lower extremities and associated with incomplete sensation to pinprick at level T7-T10. He also had painless distention of the urinary bladder. After a few hours, the weakness in his limbs increased and his sensory level rose to C5 bilaterally. A horizontal diastatic fracture across the vertebral body of C7 was discovered on plain x-ray films of the spine, and an extradural hematoma extending dorsally from C5 to T1 was revealed by emergency magnetic resonance imaging. After an emergency decompressive cervical laminectomy and removal of the clot, the patient rapidly regained complete neurological function, except with regard to both the urinary bladder and the rectum, which remained abnormal for almost 7 weeks after the operation.
报告了一例发生在一名32岁患有慢性强直性脊柱炎男性身上的颈椎创伤性硬膜外血肿。患者从站立位置跌倒约3小时后，逐渐出现感觉和运动功能障碍。患者背部着地，头部撞到地板。被扶起后，他能够自行走到附近的椅子旁坐下，直到他的左下肢——不久后右下肢也出现麻木和无力。入院时，发现患者有四肢轻瘫，下肢更为明显，且在T7 - T10水平存在针刺感觉不完全。他还出现了无痛性膀胱扩张。几小时后，他四肢的无力加重，感觉平面双侧升至C5。脊柱平片发现C7椎体有水平分离骨折，紧急磁共振成像显示硬膜外血肿从C5背侧延伸至T1。在进行紧急颈椎减压椎板切除并清除血块后，患者迅速恢复了完全的神经功能，但膀胱和直肠功能仍异常，术后近7周仍未恢复。
