自發性胸椎硬膜下血腫造成下肢癱瘓之病例報告

Low Extremity Paralysis Due to Subdural Hematoma-Case Report

傳麗蘭(Li-Lan Fu)

《物理治療》 25卷2期 (2000/03) Pp. 104-109

摘要

硬膜下血腫(subdural hematoma)、導政下肢癱瘓的病例在臨床上並不常見。發生於胸椎部位大都是急性發作的背痛，數小時內，進行性由遠端至近端的肢體感覺及運動功能完全喪失。一經確定診斷需要緊急的開刀，以減輕對脊髓的壓迫及傷害。其預後之恢復則依血腫所引起的脊髓缺氧及傷害程度而定，許多患者達到完全恢復。本報告個案是一位二十九歲的年輕女性，因背痛、取以下運動及感覺的喪失，經MRI確定為胸椎硬膜下腔血腫，經緊急的T1-3椎板切除手術並引出血腫，後經過約三個月的物理治療治療其運動功能已進步到可以用雙腋下拐獨立行走。

關鍵字

癱瘓 ； 血管異常 ； 血腫

並列摘要

How extremity paralysis due to subdural hematoma is a rare clinical condition. Acute onset severe back pain often indicate the thoracic lesion. Within hours, progressive motor and sensory loss from distal to proximal can lead to complete loss off function. Emergency surgery was necessary to relieve pressure on spinal card upon the diagnosis was made. Prognosis was depend on the severity of trauma the spinal card caused by the hematoma. Mary patients achieved complete recovery finally. This case study report a twenty-nine years old female who experienced severen backache and followed by complete motor and sensory loss. After MRI examination, and determined the thoracic subdural hematoma, the emergent T1-3 laminectomy was performed and hematoma was resected. After three months of physical therapy, patient is now walking independently with bilateral axillary crutchs.

並列關鍵字

Paralysis ； Arterio-venous malformation ； hematoma