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胸椎硬膜外血管脂肪瘤自发性出血导致的突发截瘫及文献综述

Sudden paraplegia due to spontaneous bleeding in a thoracic epidural angiolipoma and literature review.

作者信息

Lacour M, Gilard V, Marguet F, Curey S, Perez A, Derrey S

机构信息

Department of Neurology, Rouen University Hospital, 76031 Rouen, France.

Department of Neurosurgery, Rouen University Hospital, 76031 Rouen, France.

出版信息

Neurochirurgie. 2018 Mar;64(1):73-75. doi: 10.1016/j.neuchi.2017.08.003. Epub 2018 Feb 19.

Abstract

BACKGROUND

Spinal angiolipomas are rare epidural tumours that are usually revealed by chronic symptoms of medullar irritation. We report a case of acute paraplegia caused by spontaneous bleeding revealing a thoracic angiolipoma.

CASE DESCRIPTION

A 17-year-old male patient with no previous medical history was admitted for acute onset of paraplegia with bladder retention and loss of sensation in the lower limbs, preceded by dorsal pain during the three previous days. MRI showed an enhanced T1-weighted image of a T7-T12 epidural lesion. The T1-weighted isosignal and the T2-weighted hyposignal suggested haemorrhagic complications. Due to a mass effect on the spinal cord, an emergency laminectomy was performed. Histopathological examination of the lesion revealed an angiolipoma with spontaneous bleeding. Clinical outcome was favourable after two months.

CONCLUSION

This case is one of the first to be reported, although the clinical presentation is similar to that of other rare reported cases of paraplegia due to spinal compression by tumoural bleeding.

摘要

背景

脊髓血管脂肪瘤是罕见的硬膜外肿瘤,通常由脊髓受压的慢性症状所揭示。我们报告一例因自发性出血导致急性截瘫而发现的胸段血管脂肪瘤病例。

病例描述

一名既往无病史的17岁男性患者因急性截瘫入院,伴有膀胱潴留和下肢感觉丧失,在此之前的三天有背部疼痛。MRI显示T7 - T12硬膜外病变的T1加权像增强。T1加权等信号和T2加权低信号提示出血并发症。由于对脊髓的占位效应,进行了急诊椎板切除术。病变的组织病理学检查显示为伴有自发性出血的血管脂肪瘤。两个月后临床结果良好。

结论

尽管该病例的临床表现与其他因肿瘤出血导致脊髓受压而引起截瘫的罕见报道病例相似,但这是首批报道的病例之一。

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