骶管蛛网膜囊肿术后继发急性硬膜下血肿1例

Acute subdural hematoma secondary to sacral arachnoid cyst surgery:a case report

骶管囊肿多发生于神经根周围,是后方脊神经根与背根神经节连接处神经内膜与束膜之间脑脊液的聚集,其典型的临床表现包括腰背部疼痛、下肢放射痛、直肠或膀胱功能障碍等。骶管囊肿行后正中入路囊肿切除术后继发急性硬膜下血肿伴脑疝并发症较少见。甘肃省人民医院收治1例中年女性骶管囊肿患者,术后突发右侧额顶颞枕部急性硬膜下血肿,脑疝形成,紧急予以全身麻醉下硬膜下血肿清除术及骨瓣还纳术治疗,术后予以康复功能锻炼,恢复良好出院。随访患者无神经功能缺损症状。

Sacral cyst usually occurs around the nerve root,which is the accumulation of cerebrospinal fluid between the intima and the perineurium at the junction of the posterior spinal nerve root and the dorsal root ganglion.Its typical clinical manifestations include low back pain,lower limb radiation pain,rectal/bladder dysfunction and so on.Complications of acute subdural hematoma with cerebral hernia after posterior midline cystectomy of sacral cyst are rare.A middle-aged female patient with sacral cyst was admitted to Gansu Provincial Hospital.After the operation,acute subdural hematoma occurred in the right frontoparietal temporal occipital region,and cerebral herniation was formed.After the operation,the patient was given rehabilitation exercise and discharged well.No neurological deficits were observed during follow-up.