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Neurological Surgery No Shinkei Geka Volume 19, Issue 3 （March 1991）

Neurological Surgery 脳神経外科 19巻3号（1991年3月発行）

Japanese English

症例

刺創による脊髄損傷の1例 Stab Wounds of Spinal Cord by a Kitchen Knife:Report of a Case 高橋功 ¹ , 岩崎喜信 ² , 鐙谷武雄 ¹ , 今村博幸 ¹ , 宝金清博 ¹ , 斎藤久寿 ¹ , 加藤功 ² , 野村三起夫 ² , 秋野実 ² , 井須豊彦 ² , 阿部弘 ² Isao TAKAHASHI ¹ , Yoshinobu IWASAKI ² , Takeo ABUMIYA ¹ , Hiroyuki IMAMURA ¹ , Kiyohiro HOUKIN ¹ , Hisatoshi SAITOH ¹ , Tutomu KATOH ² , Mikio NOMURA ² , Minoru AKINO ² , Toyohiko ISU ² , Hiroshi ABE ² ¹札幌麻生脳神経外科病院 ²北海道大学脳神経外科 ¹Sapporo Azabu Neurosurgical Hospital ²Department of Neurological Surgery, Hokkaido University School of Medicine キーワード： Spinal cord injury , Stab wounds , MRI , Kitchen knife Keyword: Spinal cord injury , Stab wounds , MRI , Kitchen knife pp.255-258

発行日 1991年3月10日 Published Date 1991/3/10

DOI https://doi.org/10.11477/mf.1436900230

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Abstract 文献概要
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I．はじめに

　脊髄損傷の受傷原因としては一般に交通外傷，労働災害，スポーツ外傷などが多い．欧米では，上記以外にも銃砲やナイフによる脊髄損傷も稀ならず見られるが，本邦ではこれらによる損傷は極めて稀である．今回，われわれは包丁による刺創によって生じた稀な脊髄損傷を経験したので，症例を供覧するとともに若干の文献的考察を加えて報告する．

Abstract

A case of spinal cord injury clue to stab wounds by a kitchen knife is presented. A 41-year-old male was hos-pitalized because of spinal cord injury resulting from stab wounds inflicted with a kitchen knife in the post-erior cervical area.

Neurological examination on admission showed para-plegia, disappearance of deep tendon reflex in both lower extremities, sensory disturbance below T1 level, left Homer's syndrome and urinary disturbance. In addition to these symptoms cerebrospinal fluid was leaking from the wounds. An emergency operation was performed. After lami-nectomy of C7 and T1, we found that the spinal cord was almost completely split at C7/T1 level. Dural plas-ty was performed. Neurologically, sensory disturbance was sligtly improved at 4 months after the injury. Initial MRI (TR : 200msec, TE : 20msec) revealed high intensity at C7/T1 level which was damaged by the kitchen knife. MRI 5 months after the injury re-vealed low intensity on T1 weighted imaged, high in-tensity on T2 and proton weighted image.

The occurrence of the spinal cord injury due to stab wounds by a kitchen knife is very rare in Japan. MRI is useful in the diagnosis of stab wounds of the spinal cord.