突然の頚部痛と一過性左上下肢麻痺にて発症した頚髄硬膜外血腫の1例

A Case of Spinal Epidural Hematoma Presenting with Transient Hemiplegia

Ⅰ．はじめに

　頚髄硬膜外血腫は，頚部の急激な疼痛により発症することが多く，急速に運動麻痺や感覚障害を伴う比較的稀な疾患として報告されている．治療法の選択や手術時期などについては未だ議論の多いところである．今回われわれは明らかな誘因なく片麻痺を発症し，その後急速に自然寛解した頚髄硬膜外血腫の1例を経験したので報告する．

　We report a rare case of a patient with spinal epidural hematoma who presented with transient hemiplegia. A 90-year-old man awakened from sleep due to sudden neck pain. Fifteen minutes later, the man experienced progressively worsening weakness in his left hand, and was transported in an ambulance to our hospital. At the hospital, he presented with hemiplegia, and we suspected intracranial disease. Therefore, we performed magnetic resonance imaging（MRI), which revealed no intracranial lesions. Shortly after the MRI, the patient showed no signs of hemiplegia. However, since the severe neck pain persisted, we performed cervical MRI, which showed a high-intensity area at the C2-C5 level, predominantly on the left side. Despite recovery from hemiplegia, we performed a laminectomy of C3-C5 with evacuation of a hematoma at the C2-C6 level. After the surgery, the patient had no neck pain.