Anderson N E, Willoughby E W
Ann Neurol. 1987 May;21(5):470-4. doi: 10.1002/ana.410210510.
We describe 5 patients who presented with an acute cauda equina syndrome, which we believe was due to infarction of the conus medullaris. In 3 patients, the onset was spontaneous, and in 2 patients it was secondary to temporary occlusion of the distal aorta during medical manipulation. Pain in the buttocks and posterior thighs was a prominent initial symptom in the 3 patients with unprovoked attacks. The main clinical features were profound impairment of bowel and bladder function and of perianal and perineal sensation (S3 to S5 segments). There was sensory and motor impairment in the legs of variable extent, most marked in the S1 and S2 segments, but extending as high as L4 in 2 patients. In 1 patient, ischemic changes in the conus medullaris were confirmed post mortem. Ischemia confined to the caudal tip of the spinal cord is rare, and an underlying anomaly of the pattern of arterial supply is a likely predisposing factor. Four patients had partial return of function over a period of weeks.
我们描述了5例表现为急性马尾综合征的患者，我们认为这是由于脊髓圆锥梗死所致。3例患者起病为自发性，2例患者继发于医疗操作期间远端主动脉的临时闭塞。在3例无诱因发作的患者中，臀部和大腿后部疼痛是突出的初始症状。主要临床特征为肠道和膀胱功能以及肛周和会阴感觉（S3至S5节段）严重受损。腿部存在不同程度的感觉和运动障碍，在S1和S2节段最为明显，但在2例患者中高达L4节段。1例患者死后证实脊髓圆锥有缺血性改变。局限于脊髓尾端的缺血很少见，动脉供应模式的潜在异常可能是一个易感因素。4例患者在数周内功能部分恢复。
