흉추부에 발생한 자발성 척수 경막외 혈종 - 증 례 보 고 -

Spontaneous Thoracic Epidural Hematoma - Case Report -

  • 구태헌 (동국대학교 의과대학 신경외과학교실) ;
  • 목진호 (동국대학교 의과대학 신경외과학교실) ;
  • 이영배 (동국대학교 의과대학 신경외과학교실) ;
  • 박용석 (동국대학교 의과대학 신경외과학교실) ;
  • 이규춘 (동국대학교 의과대학 신경외과학교실) ;
  • 김한식 (동국대학교 의과대학 신경외과학교실)
  • Koo, Tae Heon (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
  • Mok, Jin Ho (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
  • Lee, Young Bae (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
  • Park, Yong Seok (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
  • Lee, Kye Chun (Department of Neurosurgery, College of Medicine, Dong Guk University) ;
  • Kim, Han Sik (Department of Neurosurgery, College of Medicine, Dong Guk University)
  • 투고 : 1999.05.03
  • 심사 : 1999.05.19
  • 발행 : 2000.01.28

초록

Spontaneous spinal epidural hematoma, an idiopathic accumulation of blood in the vertebral epidural space without identifiable predisposing factors, is a rare condition. The diagnosis can be made from a careful history and neurological examination, but clinical diagnosis is often difficult because of its non-specific symptomatology and it can be confused with myocardial infarct, musculoskeletal pain, vasculitis and acute dissection of an aortic aneurysm. For a favourable outcome, early decompressive laminectomy and evacuation of hematoma are necessary. We report a 50-year-old female who presented with acute paraparesis and back pain on thoracic area. Diagnosis of spinal epidural hematoma which extended over $T_4-T_9$ was made by magnetic resonance imaging. We performed immediately decompressive laminectomy and evacuated the epidural hematoma. No cause for bleeding was evident. Postoperatively, neurological symptoms disappeared within six weeks.

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