Chronic subdural hematoma coexisting with ligamentum flavum hematoma in the lumbar spine: a case report.
Chronic subdural hematoma coexisting with ligamentum flavum hematoma in the lumbar spine: a case report.
复制标题
腰椎慢性硬膜下血肿与黄韧带血肿共存：一例报告。
DOI：
10.1620/tjem.210.83
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发表时间：
2006
影响因子：
2.2
通讯作者：
E. Itoi
中科院分区：
文献类型：
--
作者：
Y. Shimada;Y. Kasukawa;N. Miyakoshi;M. Hongo;S. Ando;E. Itoi
我们提出一个病例的慢性脊髓硬膜下血肿合并黄韧带血肿在腰椎手术治疗。一名83岁妇女因心绞痛接受抗血小板药物治疗，后跌倒后出现下肢疼痛和步态障碍。放射学表现包括磁共振成像（MRI）显示黄韧带在L2 - L3水平有血肿，从L3到L5水平有慢性硬膜下血肿。通过L2至L5行椎板切除术，去除黄韧带血肿和囊性肿块。慢性硬脑膜下血肿在硬脑膜破裂后自发排出，蛛网膜完整，无脑脊液漏出。术后临床症状完全消失。据我们所知，这是第一例慢性硬膜下血肿和黄韧带血肿合并腰椎手术治疗的病例。慢性脊髓硬膜下血肿和黄韧带血肿应被认为是抗凝治疗患者进行性神经根压迫的原因，需要适当的术前诊断以实现硬膜下和硬膜外血肿的完全减压。
We present a case of a chronic spinal subdural hematoma combined with a ligamentum flavum hematoma in the lumbar spine treated surgically. An 83-year-old woman receiving antiplatelet medicine due to an angina suffered from pain in her lower extremity and gait disturbance after a backward fall. Radiological findings including magnetic resonance imaging (MRI) revealed hematoma in the ligamentum flavum at the level of L2 - L3 and a chronic subdural hematoma at the level from L3 to L5. Laminectomy through L2 to L5 was performed and a hematoma existing in the ligamentum flavum and cystic mass was removed. A chronic subdural hematoma was spontaneously evacuated after splitting of the dura mater and an intact arachnoid membrane was observed with no leakage of cerebrospinal fluid. Her clinical symptoms completely disappeared after surgery. To the best of our knowledge, this is the first case of combination of chronic subdural hematoma and ligamentum flavum hematoma in the lumbar spine treated by surgery. Chronic spinal subdural hematoma and hematoma in the ligamentum flavum should be considered as a cause of progressive nerve root compression in patients with anticoagulant therapy, and an appropriate pre-operative diagnosis would be needed to achieve complete decompression of subdural and epidural hematoma.