特発性急性脊髄硬膜外血腫の 3 例

概要

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We report three cases of spontaneous acute spinal epidural hematoma (one male and two females). Two hematomas were located at cervical levels and one at the thoracic level on the dorsal side of the spinal epidural space. There were no predisposing conditions before onset. All cases complained of sudden onset of severe back pain, followed by progressive neurological deficits. Laminectomy or laminoplasty together with evacuation of the hematomas were performed. The patients followed a satisfactory postoperative course and made quick recovery. Histologically, the small vascular tissues near the hematomas revealed a minor anomaly in the vessel walls in all cases. In patients presenting with clinical symptoms of sudden back and radicular pain with progression to paralysis, acute spinal epidural hematoma should be considered as a possible differential diagnosis. As soon as the diagnosis has been established, surgical decompression and microscopic examination for the origin of bleeding are imperative to obtain a better neurological outcome, even in patients in the chronic stage.
日本脊髄外科学会の論文
1998-03-30