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自发性脊髓硬膜外血肿所致的脊髓前动脉综合征

Anterior Cord Syndrome Due to Spontaneous Spinal Epidural Hematoma.

作者信息

Park Erin G, Seghrouchni Sarah, Bliesner Rita K, Carmona-Gonzalez Maria

机构信息

Medicine, Alabama College of Osteopathic Medicine, Dothan, USA.

Internal Medicine, Ascension Sacred Heart Pensacola, Pensacola, USA.

出版信息

Cureus. 2024 Jun 11;16(6):e62149. doi: 10.7759/cureus.62149. eCollection 2024 Jun.

DOI:10.7759/cureus.62149
PMID:38993411
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11238610/
Abstract

Spontaneous spinal epidural hematoma (SSEH) represents a rare clinical entity with an indeterminate etiology. Timely diagnosis and intervention are imperative due to the significant risk of permanent neurological deficits in the absence of appropriate treatment. This case report presents an instance of SSEH with no clear etiology. The patient arrived at the emergency department with paraplegia, urinary and fecal incontinence, and loss of pain and temperature sensation. She reported that these symptoms began abruptly after sneezing. The patient denied any pertinent medical history or family history. The patient initially experienced epigastric pain, which progressed to paresthesia. Magnetic resonance imaging confirmed an epidural hematoma extending from T2 to T8, necessitating immediate neurosurgical intervention. Although the patient was expected to recover within 72 hours postoperation, her symptoms persisted. Based on her clinical presentation, a diagnosis of anterior cord syndrome secondary to SSEH was confirmed.

摘要

自发性脊髓硬膜外血肿(SSEH)是一种病因不明的罕见临床病症。由于在未进行适当治疗的情况下存在永久性神经功能缺损的重大风险,及时诊断和干预至关重要。本病例报告展示了一例病因不明的SSEH。患者因截瘫、大小便失禁以及痛觉和温度觉丧失而被送至急诊科。她报告称这些症状在打喷嚏后突然出现。患者否认有任何相关病史或家族病史。患者最初出现上腹部疼痛,随后发展为感觉异常。磁共振成像证实硬膜外血肿从T2延伸至T8,需要立即进行神经外科干预。尽管预计患者在术后72小时内恢复,但她的症状仍持续存在。根据其临床表现,确诊为继发于SSEH的脊髓前动脉综合征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72f2/11238610/d063e690df82/cureus-0016-00000062149-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72f2/11238610/39bb1db5c389/cureus-0016-00000062149-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72f2/11238610/d063e690df82/cureus-0016-00000062149-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72f2/11238610/39bb1db5c389/cureus-0016-00000062149-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72f2/11238610/d063e690df82/cureus-0016-00000062149-i02.jpg

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本文引用的文献

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Spontaneous spinal epidural hematoma (SSEH) after cesarean section under epidural anesthesia: A case report.硬膜外麻醉下剖宫产术后自发性脊髓硬膜外血肿:一例报告
Heliyon. 2023 Nov 25;9(12):e22855. doi: 10.1016/j.heliyon.2023.e22855. eCollection 2023 Dec.
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Spontaneous spinal epidural hematoma leading to acute paraplegia: a case report.自发性脊柱硬膜外血肿导致急性截瘫:一例报告。
J Med Case Rep. 2023 Dec 14;17(1):545. doi: 10.1186/s13256-023-04297-y.
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Spontaneous resolution and complete recovery of spontaneous cervical epidural hematoma: Report of two cases and literature review.
自发性颈椎硬膜外血肿的自发消退与完全恢复:两例报告及文献综述
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