Spontaneous Spinal Epidural Hematoma Complicated by Pulmonary Embolism During Pregnancy: A Case Report.
Spontaneous Spinal Epidural Hematoma Complicated by Pulmonary Embolism During Pregnancy: A Case Report.
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妊娠期并发肺栓塞自发性脊髓硬膜外血肿一例报告
DOI：
10.3389/fmed.2022.832693
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发表时间：
2022
影响因子：
3.9
通讯作者：
Dong M
中科院分区：
文献类型：
--
作者：
Jiang W;Tan XY;Li JA;Dong M
自发性脊髓硬膜外血肿，在没有明显基础疾病的情况下，被认为是一种神经急症，在怀孕期间很少见。我们报告了一名 24 岁妊娠 37 周患者的病例。她出现背痛，并在两天内发展为双下肢截瘫。胸部磁共振成像显示脊髓后面 T5-T6 水平存在病变，提示自发性脊髓硬膜外血肿。由于紧急剖腹产后她下肢肌力恢复较快，我们采用甲基强的松龙治疗来减轻脊椎水肿，而不是进行椎管减压。我们偶然发现患者的左肺动脉被堵塞。考虑到自发性脊髓硬膜外血肿是抗凝的相对禁忌证，并且在没有肺栓塞症状（包括良好的氧分压）的情况下，我们没有进行抗凝治疗。接下来的一周，患者的病情迅速好转。自发性脊髓硬膜外血肿合并肺动脉栓塞是妊娠期间极为罕见的表现。正如我们的案例所例证的，在这种情况下，理想的治疗结果是可能的。
Spontaneous spinal epidural hematoma, without discernable underlying conditions, is considered a neurological emergency, and is rare during pregnancy. We report the case of a 24-year-old patient at 37 weeks of gestation. She had back pain that progressed to paraplegia of both lower limbs within 2 days. Thoracic magnetic resonance imaging revealed a lesion behind the spinal cord at the T5–T6 level, suggestive of spontaneous spinal epidural hematoma. Due to the rapid recovery of muscle strength in her lower limbs after an emergency cesarean section, we used methylprednisolone therapy to reduce spinal edema rather than decompression of the spinal canal. We incidentally found that the patient’s left pulmonary artery was occluded. In consideration of spontaneous spinal epidural hematoma as relative contraindication to anticoagulation, and in the absence of pulmonary embolism symptoms, including good partial oxygen pressure, we did not administer anticoagulant therapy. The patient’s condition improved rapidly in the following week. Spontaneous spinal epidural hematoma concomitant with pulmonary artery embolism is an extremely rare manifestation during pregnancy. As exemplified by our case, desirable treatment outcomes are possible under such cases.
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影响因子：
1.6
作者：
Baek, Byung Suck;Hur, Jin Woo;Lee, Hyun Koo
通讯作者：
Lee, Hyun Koo
DOI：
10.12659/ajcr.905953
发表时间：
2017-12-20
期刊：
The American journal of case reports
影响因子：
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作者：
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通讯作者：
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影响因子：
168.9
作者：
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通讯作者：
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影响因子：
2.8
作者：
Wang, Peng;Xin, Xiao-tang;Liu, Bo
通讯作者：
Liu, Bo
影响因子：
4.1
作者：
BEATTY, RM;WINSTON, KR
通讯作者：
WINSTON, KR