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婴儿创伤性颈椎硬膜外血肿:1 例罕见病例报告

An Unusual Case of Traumatic Cervical Epidural Hematoma in an Infant.

机构信息

Jeonbuk National University, School of Medicine, Department of Pediatrics, Jeonbuk, Korea.

出版信息

Turk Neurosurg. 2023;33(3):525-527. doi: 10.5137/1019-5149.JTN.41220-22.2.

Abstract

Spinal epidural hematoma (SEH) is exceedingly rare, especially in children. Acute cervical epidural hematoma presents suddenly, with progressive neurologic deficits. However, it is difficult to diagnose in infants, which results in delayed diagnosis. We report a case of rapid diagnosis of traumatic cervical epidural hematoma in an infant with successful hematoma evacuation. An 11-month-old patient was brought to the emergency department after falling backward from a o30cm-high bed. The child, who previously was able to stand without support, could not stand alone and frequently fell prone when he sat down. The brain magnetic resonance imagingshowed no abnormalities. On the spinal MRI, an acute epidural hematoma located at the C3-T1 level and pressed against the spinal cord was confirmed. Three months after surgical evacuation, the Korean version of the Bayley Scales of Infant and Toddler Development -III (K-Bayley-III) assessment was performed, and a developmental quotient (DQ) of 95 or higher was demonstrated for all parameters, including motor functions. This report described an exceedingly rare case of acute cervical epidural hematoma in an infant, induced by trauma. The diagnosis and treatment were performed within one day of injury. This process was significantly faster than other reported infantile cases of cervical epidural hematoma, which were diagnosed within 4 days to 2 months.

摘要

脊柱硬膜外血肿(SEH)极为罕见,尤其是在儿童中。急性颈段硬膜外血肿突然出现,逐渐出现神经功能缺损。然而,婴儿的诊断较为困难,导致诊断延迟。我们报告一例婴儿创伤性颈段硬膜外血肿的快速诊断,血肿成功清除。一名 11 个月大的患儿从 30cm 高的床上向后摔倒后被送到急诊室。该患儿以前能够独立站立,现在无法独自站立,坐下时经常摔倒。脑部磁共振成像未见异常。脊髓 MRI 显示 C3-T1 水平的急性硬膜外血肿,并压迫脊髓。手术后 3 个月,进行了婴儿和幼儿发展的贝利量表第三版(K-Bayley-III)评估,所有参数的发育商(DQ)均达到 95 或更高,包括运动功能。本报告描述了一例由外伤引起的婴儿急性颈段硬膜外血肿的罕见病例。损伤后 1 天内进行了诊断和治疗。这一过程明显快于其他报道的婴儿颈段硬膜外血肿病例,后者的诊断时间为 4 天至 2 个月。

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