Anterior Spinal Artery Syndrome: A Case Report

前端脊動脈症候群：病例報告

陳儀敏(Yi-Min Chen) ； 傅維仁(Helen L Po) ； 梅聖年(Shing-Nin Mei) ； 鄭碩仁(Sho-Jen Cheng)

《中華放射線醫學雜誌》 28卷1期 (2003/02) Pp. 25-30

摘要

非外傷性的脊髓缺血是不尋常的現象，特別是發生在包含頸部脊髓的情形更是少見。我們描述為一位三十歲男性在倒車之後，出現四肢偏癱併有疼痛及溫度感覺受損之情況。利用非侵入性的核磁共振攝影（MRI）及電生理檢查來協助診斷。影像學的研究顯示：在T2-weighted的影像下，一個高信號強度的病灶出現於第五頸椎至第二胸椎的上端部位。而神經傳導速度研究（NCV）則發現，上肢正中神經及雙側F波無反應以及在雙側尺神經的運動動作電位（CMAP）降低。經顱大腦皮質刺激的運動誘發電位（MEP）則出現對於四肢神經之振幅下降且中央傳導時間異常，此一情況在上肢及左側特別嚴重。在保守治療的數個月後，除了肘部及手腕的伸展肌肉外，其他大部份肌力都獲得改善。

關鍵字

前端脊動脈症候群 ； 核磁共振攝影 ； 電生理學研究

並列摘要

Nontraumatic spinal cord ischemia is uncommon, especially at the cervical spinal cord. We describe a 30-year-old man presenting with acute onset of quadriparesis and impaired sensation for pain and temperature after backing up the car. He was diagnosed noninvasively with magnetic resonance imaging (MRI) and electrophysiological studies. The image studies had revealed a high signal intensity lesion in the cord from C5 to the upper part of thoracic spinal cord (T2) on T2-weighted images. The nerve conduction velocity study (NCV) revealed non pick-up of bilateral F waves and median nerves of upper limbs with decreased compound muscle action potentials (CMAPs) of the bilateral ulnar nerves. Motor evoked potentials (MEP) after transcranial cortical stimulation revealed low amplitudes and abnormal central conduction time to the legs and arms, which was more severe on the upper limbs and especially on the left side. The patient regained most of the muscle power except extensor muscles of the elbow and wrist after conservative treatment.

並列關鍵字

anterior spinal artery syndrome ； Magnetic resonance imaging ； electrophysiological study