Cobb综合征一例

A case report of Cobb syndrome

Cobb综合征或称皮肤-脊膜-脊椎血管瘤病,是一种临床罕见的表现为同一脊椎节段的皮肤、脊椎、脊髓及内脏的血管瘤或动静脉畸形。现对近期收治的1例48岁女性Cobb综合征患者进行报道,患者因"双下肢无力3 d"就诊,发病前无明显诱因下出现左侧腰腹部疼痛,后出现双下肢无力,起病急骤,发展迅速,影像学显示C1~T11脊髓病变,与其左腮腺、左腋窝、左锁骨下、右大腿内侧皮下、肝脏右叶等处血管瘤的脊椎节段相一致,其症状、体征及影像学表现均符合Cobb综合征诊断标准。Cobb综合征在临床中极易漏诊和误诊,预后不良。文中结合相关文献对此罕见病例进行讨论与分析,以提高临床医师对Cobb综合征的认识,做到早诊断早治疗,以减少永久性神经并发症的发生。

Cobb syndrome,or cutaneomeningospinal angiomatosis,is a clinically rare manifestation of angiomatosis or arteriovenous malformations of the skin,spine,spinal cord,and viscera in the same spinal segment.A 48 years old female patient with Cobb syndrome treated ecently is reported as follow.The patient was admitted to hospital due to lower limbs weakness for three days.Left lumbar and abdominal pain occurred before onset without obvious causes,and then lower limbs weakness occurred.In this case,clinical manifestations were acute onset and development rapidly.Imaging showsed myeleterosis from C1 to T11,consistent with vertebral segments of hemangiomas in the left parotid gland,the left axillary,the left subclavian,the right femoribus internus,and the right lobe of the liver,etc.Her symptoms and imaging manifestations all meet the diagnostic criteria of Cobb syndrome.Cobb syndrome is easy to be missed diagnosis and misdiagnozed clinically with poor prognosis.This paper discussed and analyzed the rare case in combination with relevant literature,in order to improve clinicians′understanding of Cobb syndrome,so as to achieve early diagnosis and treatment,thus to reduce permanent neurological complications.