Jha Sangam, Jha Vikas Chandra, Sinha Vivek Saran
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Patna, Bihar, India.
Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar, India.
Surg Neurol Int. 2024 Aug 2;15:267. doi: 10.25259/SNI_459_2024. eCollection 2024.
Spontaneous spinal subdural-epidural hematoma during pregnancy is rare.
A 29-year-old gravida II patient experienced the onset of vomiting, headache, and progressive paraparesis. The initial non-contrast brain computed tomography and coagulation profiles were negative. The next day, the spine magnetic resonance imaging (MRI) revealed a C7-T4 epidural hematoma; contrast studies revealed no accompanying vascular lesions. On day 3, she underwent a cesarean delivery followed by a C3-T1 laminectomy. Her sensory and sphincteric function returned on postoperative day 2, but at 6 postoperative months, she continued to exhibit a 3/5 paraparesis.
Pregnant patients with acute paraparesis should undergo STAT MRI screening of the spine to look for epidural/subdural hematomas.
妊娠期自发性脊髓硬膜下-硬膜外血肿罕见。
一名29岁的二胎孕妇出现呕吐、头痛及进行性双下肢轻瘫。最初的脑部非增强计算机断层扫描及凝血检查结果均为阴性。次日,脊柱磁共振成像(MRI)显示C7 - T4硬膜外血肿;增强检查未发现伴随的血管病变。第3天,她接受了剖宫产,随后进行了C3 - T1椎板切除术。术后第2天其感觉和括约肌功能恢复,但术后6个月,她仍有3/5级双下肢轻瘫。
急性双下肢轻瘫的孕妇应立即进行脊柱MRI筛查以寻找硬膜外/硬膜下血肿。