Palma L, Mariottini A, Muzii V F, Bolognini A, Scarfò G B
Cattedra di Neurochirurgia, Università di Siena, Italy.
J Neurosurg Sci. 1994 Sep;38(3):181-5.
The authors report three cases of neurinoma of the cauda equina initially misdiagnosed as prolapsed lumbar disk. Computed Tomography failed to reveal the tumour, while showing evidence of disk-degenerative patology and being thus misleading. Similar cases are reported in literature. After a thorough analysis of the causes of such an apparently gross error, it is concluded that the main source of pitfalls arises from neglecting those typical clinical features differentiating prolapsed disk from oncogenetic sciatica. When oncogenetic sciatica is suspected Computed Tomography is inappropriate and even misleading, while the elective investigation is Magnetic Resonance.
作者报告了3例马尾神经鞘瘤，最初均被误诊为腰椎间盘突出症。计算机断层扫描未能显示肿瘤，却显示出椎间盘退变的病理迹象，从而产生了误导。文献中也报道过类似病例。在对这一明显严重错误的原因进行全面分析后得出结论，失误的主要根源在于忽视了区分椎间盘突出症与肿瘤性坐骨神经痛的那些典型临床特征。当怀疑是肿瘤性坐骨神经痛时，计算机断层扫描并不适用，甚至会产生误导，而首选的检查方法是磁共振成像。
