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自发性脊髓硬膜外血肿表现为脊髓受压和完全性截瘫的罕见病例报告及文献复习

A Rare Presentation of Spontaneous Spinal Epidural Hematoma as Spinal Cord Compression and Complete Paraplegia: A Case Report and Review of the Literature.

作者信息

Barwar Nilesh, Kumar Nitish, Sharma Amit, Bharti Ajay, Kumar Raj

机构信息

Orthopaedics, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND.

Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND.

出版信息

Cureus. 2022 Feb 14;14(2):e22199. doi: 10.7759/cureus.22199. eCollection 2022 Feb.

Abstract

Spontaneous spinal epidural hematoma (SSEH) is a serious but infrequent cause of profound neurological compromise of acute onset. It is often an atraumatic occurrence, and in around half of the cases, no etiology is identified. However, several causes such as arteriovenous malformation in the spine, use of anticoagulants in various cardiovascular diseases, and spinal trauma have been incriminated for its development. Here we encountered a case of SSEH following unregulated use of anticoagulants after a mitral valve replacement surgery. The patient had complete paraplegia with bowel and bladder involvement. The case was treated with decompressive laminectomy with regularization of her coagulation profile. Although she presented late to the healthcare center for the treatment, she showed a remarkable neurological improvement with gaining power worth near independent ambulation after one year of follow-up.

摘要

自发性脊髓硬膜外血肿(SSEH)是急性起病导致严重神经功能障碍的一个严重但不常见的原因。它通常是无创伤性发生的,并且在大约一半的病例中,未发现病因。然而,诸如脊柱动静脉畸形、各种心血管疾病中使用抗凝剂以及脊柱创伤等多种原因已被认为与它的发生有关。在此,我们遇到一例二尖瓣置换术后不规范使用抗凝剂后发生SSEH的病例。该患者出现完全性截瘫并伴有肠道和膀胱功能障碍。该病例接受了减压性椎板切除术并调整了凝血状态。尽管她到医疗中心就诊较晚,但经过一年的随访,她的神经功能有显著改善,肌力恢复到接近能够独立行走的程度。

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