Hancock J B, Field E M, Gadam R
Department of Emergency Medicine, Saint Mary's Medical Center, Saginaw, Michigan, USA.
J Emerg Med. 1997 May-Jun;15(3):309-12. doi: 10.1016/s0736-4679(97)00010-3.
A 51-yr-old woman was transferred to the emergency department with nonspecific interscapular pain and a progressive right-sided hemiparesis. Physical examination and laboratory examination revealed moderate right-sided hemiparesis, with no other focal neurologic deficits. A computed axial tomography scan of the brain was negative. Emergency arteriography revealed bilateral highgrade fibromuscular dysplasia involving the origins of the left and right common carotid arteries. The patient was admitted with the presumptive diagnosis of embolic cerebrovascular accident. Subsequently, the patient developed a left-sided sensory deficit, and magnetic resonance imaging of the cervical spine revealed a C5-T2 epidural hemorrhage. The patient underwent emergent surgical evacuation of the clot and recovered without incident. Spinal epidural hematomas are rare and typically present as cord compressions with or without pain rather than as unilateral hemiplegia.
一名51岁女性因非特异性肩胛间疼痛和进行性右侧偏瘫被转至急诊科。体格检查和实验室检查显示右侧中度偏瘫，无其他局灶性神经功能缺损。脑部计算机断层扫描结果为阴性。急诊血管造影显示双侧高级别纤维肌发育不良累及左右颈总动脉起始部。患者入院时初步诊断为栓塞性脑血管意外。随后，患者出现左侧感觉障碍，颈椎磁共振成像显示C5 - T2硬膜外出血。患者接受了紧急手术清除血肿，术后恢复顺利。脊髓硬膜外血肿罕见，通常表现为伴有或不伴有疼痛的脊髓受压，而非单侧偏瘫。
