累及胸段腹侧硬脊膜缺损的脊髓蛛网膜下腔血肿：病例说明
Spinal subarachnoid hematoma involving a thoracic ventral dural defect: illustrative case.
作者信息
Tanzawa Ayuka, Tateoka Toru, Yagi Takashi, Yoshioka Hideyuki, Ogiwara Masakazu, Kinouchi Hiroyuki
机构信息
Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Shimokato, Chuo, Yamanashi, Japan.
出版信息
J Neurosurg Case Lessons. 2024 Oct 28;8(18). doi: 10.3171/CASE24435.
BACKGROUND
Spinal subarachnoid hematoma of unknown origin is rare. Superficial siderosis has been associated with chronic bleeding from spinal dural defects; however, the relationship between these defects and spinal subarachnoid hematoma remains unclear.
OBSERVATIONS
A 32-year-old woman presenting with severe back pain and leg weakness exhibited an extensive thoracic spinal hematoma with spinal cord compression on magnetic resonance imaging. Emergency surgery was performed, which revealed a ventral subarachnoid hematoma that was evacuated. A ventral dural defect at the hematoma site and venous bleeding from the surrounding area were observed. Hemostasis was achieved and the defect closed. After surgery, her neurological symptoms quickly resolved. Postoperative spinal angiography showed no vascular lesions.
LESSONS
Like superficial siderosis, ventral spinal subarachnoid hematoma can be caused by a spinal dural defect. https://thejns.org/doi/10.3171/CASE24435.
背景
病因不明的脊髓蛛网膜下腔血肿较为罕见。浅表性铁沉积症与脊髓硬脊膜缺损的慢性出血有关；然而，这些缺损与脊髓蛛网膜下腔血肿之间的关系仍不清楚。
观察结果
一名32岁女性，出现严重背痛和腿部无力，磁共振成像显示广泛的胸段脊髓血肿伴脊髓受压。进行了急诊手术，发现为腹侧蛛网膜下腔血肿并予以清除。观察到血肿部位腹侧硬脊膜缺损及周围区域静脉出血。实现了止血并封闭了缺损。术后，她的神经症状迅速缓解。术后脊髓血管造影未显示血管病变。
经验教训
与浅表性铁沉积症一样，腹侧脊髓蛛网膜下腔血肿可能由脊髓硬脊膜缺损引起。https://thejns.org/doi/10.3171/CASE24435 。
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