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非创伤性脊髓出血:临床实践中的罕见发现。

Non-traumatic Hematomyelia: A Rare Finding in Clinical Practice.

作者信息

Claro Eva, Dias Alexandra, Girithari Geetha, Massano Ana, Duarte Maria Aurora

机构信息

Department of Internal Medicine, Centro Hospitalar do Meio Tejo, EPE, Tomar, Portugal.

Department of Neurology, Centro Hospitalar do Meio Tejo, EPE, Abrantes, Portugal.

出版信息

Eur J Case Rep Intern Med. 2018 Nov 28;5(11):000961. doi: 10.12890/2018_000961. eCollection 2018.

Abstract

UNLABELLED

Non-traumatic haematomyelia is a rare finding of acute onset, which in most cases is the result of arteriovenous malformations (AVM), tumours, coagulation disorders or autoimmune conditions, but may also be secondary to treatment with anticoagulants and radiotherapy. We present the case of a 58-year-old woman with sudden onset cervical pain, followed by asymmetric diminution of strength in the upper limbs with reduced pain sensitivity. The diagnosis of AVM at the C7 and D1 levels was made following cervico-dorsal magnetic resonance imaging and angiography. Treatment was embolization with immediate isolation of the AVM.

LEARNING POINTS

Central nervous system lesions (including subarachnoid haemorrhage) can be located in the spine as well as the brain.Subarachnoid haemorrhage can be diagnosed through examination of the cerebrospinal fluid, especially when the CT scan is normal in patients with typical signs of this condition (acute neurological deficits with pain and signs of meningeal irritation like fever or neck rigidity).Non-traumatic haematomyelia is a rare finding.

摘要

未标注

非创伤性脊髓出血是一种急性发作的罕见病症,在大多数情况下是由动静脉畸形(AVM)、肿瘤、凝血障碍或自身免疫性疾病引起的,但也可能继发于抗凝剂治疗和放射治疗。我们报告一例58岁女性病例,该患者突然出现颈部疼痛,随后上肢力量不对称减弱且疼痛敏感性降低。经颈胸段磁共振成像和血管造影检查后,诊断为C7和D1水平的动静脉畸形。治疗方法是进行栓塞并立即隔离动静脉畸形。

学习要点

中枢神经系统病变(包括蛛网膜下腔出血)可位于脊柱以及脑部。蛛网膜下腔出血可通过脑脊液检查进行诊断,特别是当CT扫描对具有该病典型体征(伴有疼痛的急性神经功能缺损以及如发热或颈部强直等脑膜刺激征)的患者显示正常时。非创伤性脊髓出血是一种罕见的病症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4cf/6346806/8225aa25cb6b/961_Fig1.jpg

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