RSS-Feed abonnieren
DOI: 10.1055/s-2002-30686
Spontanes akutes spinales subdurales Hämatom unter antikoagulativer Therapie -Falldarstellung und Literaturübersicht
Spontaneous Acute Spinal Subdural Haematoma Under Anticoagulation - Case Report and Review of LiteraturePublikationsverlauf
Publikationsdatum:
21. Mai 2002 (online)
Zusammenfassung
Akute spinale subdurale Hämatome stellen eine seltene Ursache für Rückenmarkkompressionssyndrome dar. Sie treten meist bei Patienten mit einer gestörten Blutgerinnung auf. Diese Falldarstellung berichtet über ein spontan aufgetretenes subdurales Hämatom, diagnostiziert mittels NMR und behandelt über einen minimal invasiven operativen Zugang. Wir betonen, dass mit Hilfe der NMR-Untersuchung zur Operationsplanung der Zugang so zu minimieren ist, dass eine Laminektomie nur selten erforderlich ist.
Abstract
Acute spinal subdural haematoma is a rare cause of spinal cord compression which occurs mainly in patients with a bleeding diathesis. This report presents a case of a spontaneous spinal subdural haematoma demonstrated by magnetic resonance imaging (MRI) and treated by a minimal invasive operation. We would like to stress that laminectomy is rarely neccesary with MRI examination for planning of the neurosurgical operation.
Literatur
- 1 Schiller F, Neligan G, Budtz-Olsen O. Surgery in haemophilia: a case of spinal subdural haematoma producing paraplegia. Lancet. 1948; 2 842-845
- 2 Domenicucci M, Ramieri A, Ciapetta P, Delfini R. Nontraumatic acute spinal subdural hematoma: report of five cases and review of the literature. J Neurosurg. 1999; 91, Suppl 1 65-73
- 3 Morandi X, Carsin-Nicol B, Brassier G, Scarabin J M. MR demonstration of spontaneous acute spinal subdural hematoma. J Neuroradiol. 1998; 25 46-48
- 4 Kulkarni A V, Willinsky R A, Gray T, Cusimano M D. Serial magnetic resonance imaging findings for a spontanously resolving spinal subdural hematoma: Case report. Neurosurg. 1998; 42 398-401
- 5 Langmayr J J, Ortler M, Dessl A. et al . Management of spontanous extramedullary spinal haematomas: Results in eight patients after MRI diagnosis and surgical decompression. J Neurol Neurosurg Psychiatry. 1995; 59 442-447
- 6 Schwann K W, Ropper A H, New P FJ, Poletti C HE. Spontanous spinal subarachnoid hemorrhage and subdural hematoma. J Neurosurg. 1984; 61 975-980
- 7 Levy J M. Spontanous lumbar subdural hematoma. AJNR. 1990; 11 780-781
- 8 Pryle B J, Carter J A, Cadoux-Hudson T. Delayed paraplegia following spinal anaesthesia. Spinal subdural haematoma following dural puncture with a 25G pencil point needle at T12 - L1 in a patient taking aspirin. Anaesthesia. 1996; 51 263-265
- 9 Boukobza M, Guichard J P, Boissonet M. et al . Spinal epidural haematoma: report of 11 cases and review of the literature. Neuroradiology. 1994; 36 456-459
- 10 Calhoun J M, Boop F. Spontanous spinal subdural hematoma: case report and review of the literature. Neurosurgery. 1991; 29 133-134
- 11 Johnson P J, Hahn F, McConnel J. et al . The importance of MRI findings for the diagnosis of nontraumatic lumbar subacute subdural haematomas. Acta Neurochir (Wien). 1991; 113 186-188
- 12 Felber S, Langmaier J, Judmaier W. et al . Magnetresonanztomographie bei epiduralen und subduralen spinalen Hämatomen. Radiologe. 1994; 34 656-661
- 13 Post M J, Becerra J L, Madsen P W. et al . Acute spinal subdural hematoma: MR and CT findings with pathologic correlates. AJNR. 1994; 15 1895-1905
- 14 Jacquet G, Godard J, Orabi M. et al . Spinal subdural hematoma. Zentralbl Neurochir. 1991; 52 131-135
- 15 Mavroudakis N, Levivier M, Rodesch G. Central cord syndrome due to a spontanously regressive spinal subdural hematoma. Neurology. 1990; 40 1306-1308
Dr. Michael Zimmermann
Neurochirurgische Universitätsklinik Bochum
In der Schornau 23 - 25
44892 Bochum