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溶栓后灾难性自发性脊髓硬膜外血肿:神经外科与心脏科挑战的交集——机构经验

Catastrophic spontaneous spinal epidural hematoma following thrombolysis: An intersection of neurosurgical and cardiological challenges - An institutional experience.

作者信息

Soni Tushar V, Patel Shreyansh J, Shah Varshesh K, Joshipura Kavan M

机构信息

Department of Neurosurgery, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.

出版信息

J Craniovertebr Junction Spine. 2024 Jul-Sep;15(3):371-374. doi: 10.4103/jcvjs.jcvjs_62_24. Epub 2024 Sep 12.

Abstract

Catastrophic spontaneous spinal epidural hematoma (SSEH) following thrombolysis poses a complex intersection of neurosurgical and cardiological challenges. This case report presents the institutional experience of a 66-year-old female who developed rapid-onset compressive myelopathy after thrombolysis for inferior wall myocardial infarction with injection streptokinase. SSEH, although rare, demands prompt recognition due to its potential for permanent neurologic injury and mortality. The discussion highlights the clinical significance, anatomical considerations, and multidisciplinary approach requisite for accurate diagnosis and effective management of SSEH. The conclusion underscores the necessity for clinicians, particularly cardiologists administering thrombolytic therapies, to consider SSEH in postthrombolysis patients presenting with neurological deficits.

摘要

溶栓后发生的灾难性自发性脊髓硬膜外血肿(SSEH)带来了神经外科和心脏病学方面的复杂挑战。本病例报告介绍了一名66岁女性的机构经验,该女性在接受链激酶注射溶栓治疗下壁心肌梗死后迅速出现压迫性脊髓病。SSEH虽然罕见,但因其有导致永久性神经损伤和死亡的可能性,需要及时识别。讨论强调了SSEH准确诊断和有效管理所需的临床意义、解剖学考虑因素以及多学科方法。结论强调临床医生,尤其是实施溶栓治疗的心脏病学家,有必要在出现神经功能缺损的溶栓后患者中考虑SSEH。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b97/11524568/493ddabe6979/JCVJS-15-371-g001.jpg

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