Zhou Li-Li, Zhu Shi-Guo, Fang Yuan, Huang Shi-Shi, Huang Jie-Fan, Hu Ze-Di, Chen Jin-Yu, Zhang Xiong, Wang Jian-Yong
Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.
World J Clin Cases. 2022 Nov 16;10(32):11835-11844. doi: 10.12998/wjcc.v10.i32.11835.
Cervical myelopathy is a potential stroke imitator, for which intravenous thrombolysis would be catastrophic.
We herein present two cases of cervical myelopathy. The first patient presented with acute onset of right hemiparesis and urinary incontinence, and the second patient presented with sudden-onset right leg monoplegia. The initial diagnoses for both of them were ischemic stroke. However, both of them lacked cranial nerve symptom and suffered neck pain at the beginning of onset. Their cervical spinal cord lesions were finally confirmed by cervical computed tomography. A literature review showed that neck pain and absence of cranial nerve symptom are clues of cervical myelopathy.
The current report and the review remind us to pay more attention to these two clues in suspected stroke patients, especially those within the thrombolytic time window.
脊髓型颈椎病可能会被误诊为中风，而对此进行静脉溶栓可能会带来灾难性后果。
我们在此报告两例脊髓型颈椎病病例。首例患者急性起病，出现右侧偏瘫和尿失禁，第二例患者突然出现右腿单瘫。两人最初的诊断均为缺血性中风。然而，他们在发病初期均缺乏颅神经症状且伴有颈部疼痛。最终通过颈椎计算机断层扫描确诊为颈脊髓病变。文献综述表明，颈部疼痛和无颅神经症状是脊髓型颈椎病的线索。
本报告及综述提醒我们，对于疑似中风患者，尤其是处于溶栓时间窗内的患者，要更加关注这两条线索。
