Spontaneous Spinal Epidural Hematoma with Initial Presentation Mimicking Aortic Dissection

初期被誤判為主動脈剝離之自發性脊髓硬膜外血腫

田知學(Felice Tien) ； 陳麗美(Li-Mei Chen) ； 陳振德(Chen-De Chen) ； 呂佳璘(Chia-Lin Lu) ； 林健盛(Chien-Sheng Lin)

《中華民國急救加護醫學會雜誌》 19卷4期 (2008/12) Pp. 167-171

https://doi.org/10.30018/JECCM.200812.0005

摘要

對淤多數臨床醫師而言，自發性脊髓硬膜外血腫是一個造成非創傷性脊髓神經功能障礙的罕見原因。一位有高血壓病史但不按時服藥的五十歲男性因為急性上背痛合併轉移至前胸處來到急診室，核磁掃瞄顯示疑似急性自發性脊髓硬膜外血腫。經緊急手術之後，病患恢復狀況良好。自發性脊髓硬膜外血腫臨床表現多變化，可以由輕微背痛至四肢癱瘓，校磁掃瞄對於診斷及追蹤都很有幫助，目前手術為治療主項。及早診斷和積極治療對病患預後有很大的幫助。

關鍵字

背痛 ； 高血壓 ； 核磁掃描 ； 自發性脊髓硬膜外血腫 ； 手術治療

並列摘要

Spontaneous spinal epidural hematoma (SSEH) is a rare cause of acute noutraumatic myelopathy. A 50-year-old man presented with sadden onset of severe hack pain wit/i radiation to the chest. Initially he had no neurologic dysfunction, hut he developed bilateral lower leg weakness one day after admission. The diagnosis was made by magnetic resonance imaging. An emergency decompressive leminectomy revealed a spinal epidural hematoma from C7 to T6, which may have been provoked by transient elevation of uncontrolled hypertension. The patient was discharged with improvement.
The clinical picture of SSEH demonstrates a wide range of symptoms and it may be underestimated. Surgical intervention is still the mainstay of treatment. Early diagnosis and appropriate treatment are important for an optimal neurologic outcome.

並列關鍵字

back pain ； hypertension ； magnetic resonance ； surgical intervention resonance imaging ； spontaneous spinal epidural