Spontaneous Cervical Epidural Hematoma Presented with Brown-Sequard Syndrome: A Case Report

自發性頸部硬腦膜外血腫（以布朗氏症候群表現）

周德陽(Deh-Yang Chou) ； 張光雄(Cecil Guang-Shiung Chung) ； 楊大羽(Dar-Yu Yang)

《The Kaohsiung Journal of Medical Sciences》 4卷1期 (1988/01) Pp. 58-62

https://doi.org/10.6452/KJMS.198801.0058

摘要

自發性頸部硬腦膜外出血在文獻上是很少報告的。至今共43例，而合併布朗氏症候群只有3例。我們現在報告一位75歲女性因突然右半身癱瘓，合併布朗氏症候群及小便貯留有三天之久。由脊髓攝影顯示對比劑於第四頸椎以下完全阻斷，於電腦斷層攝影顯示在頸部第三至第六頸椎之右後側有硬腦膜外血塊壓迫。病人因頭痛及兩側髖關節股骨頭壞死有長期服用止痛劑習慣，但手術時之凝血機能仍在正常範圍內。於三天後經過緊急手術，作第三至第七頸椎切除及除去血塊。一個月後病人肢體功能幾乎恢復正常，布朗氏症候群緩解。自發性頸部硬腦膜外血腫是個外科急症。早期診斷，早期治療，其預後良好。

並列摘要

Spontaneous cervical epidural hematoma has rarely been reported in the literature. This present study is of a case of a 75-year-old woman who had a sudden onset of neck pain with the accompanying right hemiplegia of Brown-Sequard syndrome, and urinary retention for 3 days prior to surgery. The patient had used long term Sedes treatment for arthropathy of bilateral hips and no trauma history was found at this episode. Computered tomography (CT) of the cervical spine showed an epidural hematoma over the right posterior aspect of C-3 to C-6 with compression of the spinal cord. Myelography of the cervical spine revealed a complete block below the C-4 level. She underwent a posterior total laminectomy of C-3 to C-7 with evacuation of the hematoma. Upon discharge, only mild residual numbness of the left leg remained. The follow-up of cervical myelography showed the spinal canal was patent. The authors conclude that high resolution CT scanning and surgical treatment are crucial to the outcome of such surgery.

並列關鍵字

spontaneous cervical epidural hematoma ； Brown-Sequard syndrome