颈椎急性自发性硬膜外血肿的诊治

Diagnosis and treatment of acute cervical spontaneous spinal epidural hematomas

目的探讨颈椎急性自发性硬膜外血肿(ACSSEH)的诊断和治疗。方法对5例ACSSEH患者行MRI检查,根据临床表现和影像学特点进行诊断和治疗。患者均有不同程度脊髓压迫症状,确诊后行椎管减压血肿清除术。结果1例死亡;4例获得8个月～3年随访。神经功能:2例恢复至FrankelE级,2例与出院时比较无明显改善。结论项颈部疼痛是ACESSH早期症状,MRI可早期确诊。早期手术者神经功能恢复较好。

Objective To analyze the diagnosis and treatment of acute cervical spontaneous spinal epidural hematomas（ACSSEH）. Methods 5 patients with ACSSEH were checked by MR images,and diagosed according to the clinical manifestations and MR images. 5 cases were complicated with neural compression and undergone surgery for hemotoma clearance. Results 1 died. Favorable postoperative functional results were found in 3 cases immediately,4 cases were followed up for 836 months,the neurological function of 2 cases recovered to Frankel E finally,and the neurological function of 2 cases had no statistical difference than the postoperative function. Conclusions Pain involving the back of neck is the early clinical manifestations of ACSSEH,which was diagnosed by MRI before all others. The early operative treament,the better neurologic function recovery.