Isaji Taiki, Yukiue Tadato, Amano Takayuki
Department of Neurosurgery, Nagoya Tokushukai General Hospital, 2-52 Kozojikita, Kasugai, Aichi 487-0016, Japan.
Oxf Med Case Reports. 2024 Aug 6;2024(8):omae086. doi: 10.1093/omcr/omae086. eCollection 2024 Aug.
A delayed presentation of traumatic spinal epidural hematoma (SEH) is a rare disease in which most patients are asymptomatic for days to weeks after the injury, followed by pain and then a neurological deficit. A 66-year-old woman who suffered a fractured right clavicle due to a bicycle accident 42 days previously, presented with left shoulder pain and left hemiplegia. The manual muscle test (MMT) scores of the left upper and lower limbs were all 1. Computed tomography and magnetic resonance imaging showed no cervical fracture but showed cervical epidural hematoma. She underwent surgery for the removal of the SEH. Her MMT score improved to 4 at 10 days after surgery. Even in cases with a delayed presentation, suspecting SEH can help clinicians make an early diagnosis. Additionally, the prompt surgical evacuation of the SEH can lead to favorable neurological outcomes in symptomatic cases.
创伤性脊髓硬膜外血肿（SEH）延迟表现是一种罕见疾病，大多数患者在受伤后数天至数周内无症状，随后出现疼痛，继而出现神经功能缺损。一名66岁女性在42天前因自行车事故导致右锁骨骨折，现出现左肩疼痛和左侧偏瘫。左上肢和下肢的徒手肌力测试（MMT）评分均为1分。计算机断层扫描和磁共振成像显示无颈椎骨折，但显示颈椎硬膜外血肿。她接受了手术以清除SEH。术后10天，她的MMT评分提高到了4分。即使在延迟表现的病例中，怀疑SEH也有助于临床医生早期诊断。此外，对于有症状的病例，及时手术清除SEH可带来良好的神经功能预后。
