Journal of Korean Neurosurgical Society

  • 제57권3호
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  • Pages.215-218
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  • 2015
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Delayed Diagnosis of Probable Radiation Induced Spinal Cord Vascular Disorders

  • Won, Young Il (Department of Neurosurgery, Seoul National University Hospital) ;
  • Kim, Chi Heon (Department of Neurosurgery, Seoul National University Hospital) ;
  • Chung, Chun Kee (Department of Neurosurgery, Seoul National University Hospital) ;
  • Yun, Tae Jin (Department of Radiology, Seoul National University Hospital)
  • 투고 : 2014.06.10
  • 심사 : 2014.08.13
  • 발행 : 2015.03.28
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초록

Occasionally, unexpected neurological deficits occur after lumbar spinal surgery. We report a case of monoparesis after lumbar decompressive surgery. A 63-year-old man, who had undergone decompression of L4-5 for spinal stenosis 4 days previously in the other hospital, visted the emergency department with progressive weakness in the left leg and hypoesthesia below sensory level T7 on the right side. He had been cured of lung cancer with chemotherapy and radiation therapy 10 years previously, but detailed information of radiotherapy was not available. Whole spine magnetic resonance (MR) imaging showed fatty marrow change from T1 to T8, most likely due to previous irradiation. The T2-weighted MR image showed a high-signal T4-5 spinal cord lesion surrounded by a low signal rim, and the T1-weighted MR image showed focal high signal intensity with focal enhancement. The radiological diagnosis was vascular disorders with suspicious bleeding. Surgical removal was refused by the patient. With rehabilitation, the patient could walk independently without assistance 2 months later. Considering radiation induced change at thoracic vertebrae, vascular disorders may be induced by irradiation. If the spinal cord was previously irradiated, radiation induced vascular disorders needs to be considered.

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참고문헌

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피인용 문헌

  1. Sudden spinal hemorrhage in a pediatric case with total body irradiation‐induced cavernous hemangioma vol.65, pp.10, 2015, https://doi.org/10.1002/pbc.27250