Kneisley L W
Arch Neurol. 1977 Sep;34(9):536-9. doi: 10.1001/archneur.1977.00500210038005.
A 20-year-old man suffered head, chest, and abdominal trauma in an auto accident resulting in a traumatic dissecting aneurysm of the thoracic aorta. Hypotension developed. The aneurysm was resected and replaced with a prosthetic graft. Postoperatively, the patient was found to be paraplegic below T-9, areflexic and anesthetic to pain and temperature, with preservation of vibration and position senses. In the ensuing nine months, the patient regained considerable sensory function in his lower extremities and had severe constant hyperhydrosis below the T-9 dermatome. The exaggerated sweating was unaffected by temperature change and anxiety. It was diminished by methantheline bromide treatment but never abolished. The spinal cord lesion is postulated to be anterior horn cell loss, with preservation of interneurons and intermediolateral gray columns. Disinhibition of sympthetic circuits or sprouting of axons are proposed mechanisms.
一名20岁男性在一场车祸中头部、胸部和腹部受到创伤，导致创伤性胸主动脉夹层动脉瘤。出现了低血压。动脉瘤被切除并用人工血管替换。术后，发现患者T - 9以下截瘫，无反射，对疼痛和温度无感觉，但振动觉和位置觉保留。在随后的九个月里，患者下肢恢复了相当多的感觉功能，并且在T - 9皮节以下有严重的持续性多汗症。出汗过多不受温度变化和焦虑的影响。用溴甲贝那替秦治疗后有所减轻，但从未完全消除。推测脊髓病变是前角细胞丢失，中间神经元和中间外侧灰质柱保留。提出的机制是交感神经回路的去抑制或轴突发芽。
