雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

CHRONIC CERVICAL EPIDURAL HEMATOMA DIAGNOSED BY MAGNETIC RESONANCE IMAGING Toru Imamura 1,2 , Kenji Tsuburaya 1 1Department of Neurology, Tohoku Kohseinenkin Hospital 2Department of Neurology, Institute of Brain Diseases, Tohoku University School of Medicine Keyword: spinal epidural hematoma , chronic course , magnetic resonance imaging , venous bleeding pp.857-861
Published Date 1990/9/1
DOI https://doi.org/10.11477/mf.1406900097
  • Abstract
  • Look Inside

The clinical picture of spinal epidural hema-toma is usually characterized by the sudden onset of pain and acute paraplegia within a few hours. The reports of chronic spinal epidural hematoma above the lumbar level is extremely rare. Here we added one case whose hematoma was at cervical level. A 31-year-old previously healthy male suffered from continuous sharp pain in the back of his neck about 10 weeks before admission. He took analgesic drugs and treated with head traction by his home doctor with minimal relief. 4 weeks later from onset progres-sive weakness and numbness appeared at his right hand and arm. Physical examination on admission revealed mild monoparesis and sensory disturbance in his right upper limb. There was hyporefiexia of both upper extremities. Magneticresonance imaging (MRI ; Hitachi O.2 T) visua-lized a dorsal epidural space occupying lesion extending from C3 to Th1 vertebral body level. This revealed high signal intensity in T2 weighted image and mixed (low and iso) signal intensity in T1 weighted image corresponding to old hematoma. All his medication was stopped and he treated with collar brace, which improved his neurological status. 3 weeks later, he recovered fully and follow-up MRI revealed the total abso-rption of the hematoma. Left vertebral angiogram showed that a part of posterior cerebral venous blood drained to cervical vertebral plexus. This finding suggested his epidural bleeding was venous in origin.

Rupture of internal vertebral venous plexus that has no valves was considered as the source of spinal epidural hematoma. But a recent view regards it arterial in origin because its acute clinical course suggests rapidly expanding hema-toma and can be explained only by arterial ble-eding pressure. We agree this and discussed the recurrent venous bleedings, each of them may be brief for the compression of intrathecal pressure, as the possible mechanism of chronic spinal epidural hematoma.


Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

関連文献

もっと見る

文献を共有