Taha A, Bakker S L M
Erasmus MC, afd. Neurologie, Rotterdam.
Ned Tijdschr Geneeskd. 2018;162:D1982.
In patients with pre-existent cervical spinal canal stenosis, minimal trauma, leading to neck hyperextension, can cause a significant increase of spinal cord compression. However, spinal cord injury is generally associated with major trauma and is usually not expected in patients with minor trauma. The resulting symptoms are diverse, making it even more difficult to diagnose. To illustrate the variety in symptoms at presentation, we describe two male patients aged 66 and 69. Rapid diagnosis is important as acute neurosurgical intervention may be indicated. Physical neurological examination, and in particular testing peripheral reflexes, can contribute to the rapid diagnosis of spinal cord injury. Cervical spine CT should not only be assessed for acute traumatic injury, but also for possible stenosis of the cervical spinal canal.
在已有颈椎管狭窄的患者中，导致颈部过伸的轻微创伤可引起脊髓压迫显著增加。然而，脊髓损伤通常与重大创伤相关，轻度创伤患者一般不会出现。由此产生的症状多种多样，这使得诊断更加困难。为说明就诊时症状的多样性，我们描述两名年龄分别为66岁和69岁的男性患者。由于可能需要进行急性神经外科干预，快速诊断很重要。体格神经检查，尤其是检测外周反射，有助于脊髓损伤的快速诊断。颈椎CT不仅应评估急性创伤损伤，还应评估颈椎管可能存在的狭窄情况。
