急性自发性硬脊膜外血肿早期诊治

目的总结急性自发性硬脊膜外血肿的临床特点和治疗。方法对近年收治的8例患者病因、临床表现、影像学特征、治疗及预后相关因素进行了回顾性分析。结果所有患者均无明确病因,MRI检查多表现为椎管背侧梭形或条索状占位影,其中4例位于胸椎,2例位于腰椎,颈椎2例,范围2～5个椎体。确诊后尽早行椎板减压及血肿清除术,起病24小时内手术的7例恢复良好,另1例因误诊致发病后50小时才手术,疗效不佳。结论MRI是确诊本病的可靠手段,早期诊断、及时手术是改善患者预后的关键。

Diagnosis and Treatment of Acute Spontaneous Spinal Epidural Hematoma: Report of 8 cases

Objective To summarize the clinical features and treatment for the patients with acute spontaneous spinal epidural hematoma.Methods We retrospectively studied the causes of hemorrhage,clinical presentation,MR images,diagnosis and therapy in 8 cases operated in recent years.Results All patients had no specific cause with semilunar space occupying mass in posterior of the spinal canal on MR imaging.All patients were decompressed as early as possible,7 of them operated within 24 hours since the onset recovered well and the another operated after 50 hours because of misdiagnosis recovered poor.Conclusions MRI is the optimal choice for the diagnosis of acute spontaneous spinal epidural hematoma.Early diagnosis and decompression of spinal cord is crucial to neurological function recovery.