MacDonald R L, Findlay J M, Tator C H
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Ontario, Canada.
J Neurosurg. 1988 Mar;68(3):466-71. doi: 10.3171/jns.1988.68.3.0466.
Two cases of progressive myelopathy occurring years after incomplete cervical spinal cord injury are presented. In both patients, the clinical features, as well as the "bull's-eye" appearance of the delayed computerized tomography (CT) myelography study and the circumscribed low density of the magnetic resonance image, were consistent with posttraumatic syringomyelia, but surgical exploration including intra-operative spinal sonography failed to reveal a syrinx. Although arachnoiditis was present in both patients, the striking abnormality found at surgery was the softened appearance and the microcystic degeneration of the cord. The microcystic spinal cord degeneration found in these cases represents a previously undescribed cause of late deterioration after spinal cord injury that may mimic the clinical, CT-myelographic, and magnetic resonance features of posttraumatic syringomyelia.
本文报告了两例在不完全性颈脊髓损伤数年之后发生进行性脊髓病的病例。两名患者的临床特征，以及延迟计算机断层扫描（CT）脊髓造影检查呈现的“靶心”外观和磁共振图像的局限性低密度影，均与创伤后脊髓空洞症相符，但包括术中脊髓超声检查在内的手术探查均未发现脊髓空洞。尽管两名患者均存在蛛网膜炎，但手术中发现的显著异常是脊髓外观软化和微囊性变性。这些病例中发现的微囊性脊髓变性代表了脊髓损伤后晚期病情恶化的一种此前未被描述的原因，其可能酷似创伤后脊髓空洞症的临床、CT脊髓造影及磁共振特征。
