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[自发性脊髓硬膜外血肿——一例报告(作者译)]

[Spontaneous spinal epidural hematoma--report of a case (author's transl)].

作者信息

Enomoto T, Maki Y, Nakagawa K, Nose T

出版信息

No Shinkei Geka. 1980 Sep;8(9):875-80.

PMID:7432601
Abstract

A typical case of spontaneous spinal epidural hematoma was reported. The patient was a 52 year-old male. He suddenly developed severe high back pain followed by complete paraplegia and rectovesical insufficiency. Myelography disclosed epidural mass extending fro Th2 t0 Th4. Laminectomy and removal of hematoma were carried out 4 days after the onset. Post-operative course was uneventful. Four months later he began to walk with the aids and 7 months later he was fully ambulatory and discharged. We analysed 110 cases already reported including our own and obtained the following conclusions. Spontaneous spinal epidural hematoma was 67% and secondary one 33%. The most frequent precipitating factor was usage of anticoagulant followed by trauma and vascular anomaly. There were relatively many case below the age of 15. The level of lesion predominated in thoracic region. Early operation was imperative but even in delayed cases good result could be expected especially in younger patient and those with lumbal lesion.

摘要

报告了一例典型的自发性脊髓硬膜外血肿病例。患者为一名52岁男性。他突然出现严重的腰背部疼痛,随后发展为完全性截瘫和直肠膀胱功能障碍。脊髓造影显示硬膜外肿块从胸2延伸至胸4。发病4天后进行了椎板切除术并清除血肿。术后过程顺利。四个月后他开始借助辅助器具行走,七个月后他能够完全自主行走并出院。我们分析了包括我们自己的病例在内的已报告的110例病例,得出以下结论。自发性脊髓硬膜外血肿占67%,继发性血肿占33%。最常见的诱发因素是使用抗凝剂,其次是创伤和血管异常。15岁以下的病例相对较多。病变部位主要在胸部。早期手术是必要的,但即使在延迟手术的病例中,尤其是年轻患者和腰部病变患者,也可能预期有良好的结果。

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