以胸髓半切症候群為表現之潛水夫病後遺症：一病例報告

Syndrome of Hemisection of the Thoracic Cord as a Sequela of the Caisson Disease

張佐文(Tso-Wen Chang) ； 林隆義(Roy Lin) ； 劉安邦(An-Bang Liu) ； 林堅熙(Chein-Hsi Lin) ； 鄧子雲(Tze-Wan Tang)

《慈濟醫學雜誌》 4卷4期 (1992/12) Pp. 253-256

https://doi.org/10.6440/TZUCMJ.199212.0253

摘要

潛水夫病係由於浮上水面之減壓過程中，已經溶於體液或組織中之氣體再度釋放出來而導致。本文報告一37歲男性潛水夫病患者，發病一年後仍呈現罕見之脊髓半切症候群，左下肢錐體體徑病徵明顯且合併擃動感覺缺失，右下肢痛溫覺消失。經脊髓造影術及電腦斷層掃搭顯示下醹頸髓又胸髓呈現整個萎縮，並無腫瘤、軟組織、骨質、血塊或其住壓迫性脊髓病灶，此病人之脊髓半切症候群無法由脊部皆原因或為脊髓左側受氣泡壓迫之故。

關鍵字

潛水大病 ； 減壓病 ； 脊髓半切症候群

並列摘要

Caisson disease or decompression sickness is recognized to be due to the liberation of the gases previously dissolved in body liquids under increased pressure. Rapid reduction in ambient pressure may cause the forma-tion and growth of gas bubbles within supersaturated body liquids and tissues, resulting in damage of the central nervous system, cardiorespiratory system and the limbs. We presented a 37-year-old male who suffered from Caisson disease one year prior to admission. Neurological examination revealed a syndrome of hemisec-tion of the spinal cord or Brown-Sequard syndrome, manifest with prominent pyramidal tract signs and loss of vibratory sensation on the left lower limb, and lossof superficial and temperature sensation on the right lower limb below the level of about T 10. Myelography and spinal CT disclosed thoracic cord atrophy. Lesion ca not be explained by the vessel distribution of spinal cord. We thus suggested that the spinal cord involvement in the present case was possibly related to a mechanism othan than vascular occlusion.

並列關鍵字

caisson disease ； decompression sickness ； syndrome of hemisection of the spinal cord ； Brown-Sequard syndrome