Basile Luigi, Brunasso Lara, Gerardi Rosa Maria, Maugeri Rosario, Iacopino Domenico Gerardo, Gulì Carlo, Pino Maria Angela, Tumbiolo Silvana, Nicoletti Giovanni Federico, Graziano Francesca
Department of Neurosurgery, Neurosurgical Clinic, AOUP "Paolo Giaccone", Post Graduate Residency Program in Neurosurgery, Italy.
Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Palermo, Italy.
Surg Neurol Int. 2020 Oct 21;11:348. doi: 10.25259/SNI_407_2020. eCollection 2020.
Because the neurological presentation of spinal epidural hematomas (SEH) is often not specific, they may be misdiagnosed as acute lumbar disk herniations. Here, we present a case in which a traumatic disc extrusion mimicked an epidural hematoma and reviewed the appropriate literature.
A 27-year-old male sustained a high-energy fall. The lumbar MRI scan showed a L4-S1 ventral medium/high signal intensity mass on the T1- and high signal intensity lesion on T2-weighted images; the original diagnosis was spinal epidural hematoma. However, at surgery, consisting of a left L4 and L5 hemilaminectomy with L4-L5 and L5-S1 laminotomy, an extruded lumbar disc was encountered at the L4-L5 level and removed; no additional pathology or SEH was found at either level.
On MR, SEH may mimic acute lumbar disk herniations. Depending on the clinical symptoms/signs, surgical intervention will both correctly confirm the diagnosis and relieve neural compression.
由于脊髓硬膜外血肿（SEH）的神经学表现通常不具有特异性，它们可能被误诊为急性腰椎间盘突出症。在此，我们报告一例创伤性椎间盘突出模仿硬膜外血肿的病例，并复习相关文献。
一名27岁男性遭受高能量坠落伤。腰椎MRI扫描显示L4-S1水平腹侧在T1加权像上呈中等/高信号强度肿块，在T2加权像上呈高信号强度病变；最初诊断为脊髓硬膜外血肿。然而，在手术中，行左侧L4和L5半椎板切除术以及L4-L5和L5-S1椎板切开术时，在L4-L5水平发现一个突出的腰椎间盘并将其切除；在这两个水平均未发现其他病变或脊髓硬膜外血肿。
在磁共振成像上，脊髓硬膜外血肿可能模仿急性腰椎间盘突出症。根据临床症状/体征，手术干预既能正确确诊，又能缓解神经压迫。
