胸硬膜外动静脉畸形引起快速进行性脊髓病和模拟急性横断面脊髓炎:1例报告

Ibrain Pub Date : 2022-10-26 DOI:10.1002/ibra.12070
Hao Yuan, Yu Pi, Hong-Su Zhou, Chong Wang, Wei Liu, Yong-Min Niu, Yang Lan, Dong Chen, Shi-Ran Liu, Shun-Wu Xiao
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引用次数: 0

摘要

脊髓动静脉畸形(AVMs)合并急性自发性出血的临床症状缺乏特异性,容易导致误诊和延误治疗。本研究旨在分析误诊原因,并对诊断和治疗要点进行综述。我们提出了一个极其罕见的病例,25岁的男子,其临床特征模拟急性横贯脊髓炎,患有快速和反复进行性脊髓病伴肿块。病理诊断为AVM;在术后12个月的随访期间进行以症状为基础的手术治疗,包括后路减压和硬膜外avm的移除。双下肢近端和远端肌肉手工肌肉测试分级由1分提高到5分,美国脊髓损伤协会运动和感觉分级由B分提高到e分。如果出现原因不明的突然或进行性脊髓损伤和急性脊髓功能障碍,可能存在误诊。鉴别诊断的关键是要考虑到动静脉畸形,同时也要怀疑自发性出血和血肿。血管造影和磁共振成像对AVM的诊断非常重要,我们希望能提高临床医生对此类疾病的认识和警惕。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Thoracic epidural arteriovenous malformation causing rapidly progressive myelopathy and mimicking an acute transverse myelitis: A case report

Thoracic epidural arteriovenous malformation causing rapidly progressive myelopathy and mimicking an acute transverse myelitis: A case report

Clinical symptoms of spinal arteriovenous malformations (AVMs) combined with acute spontaneous hemorrhage lack specificity, which leads to misdiagnosis and delays treatment. The current study aimed to analyze the causes of misdiagnosis and review the key points of diagnosis and treatment. We presented an extremely rare case of a 25-year-old man whose clinical characteristics mimicked acute transverse myelitis, suffering from rapidly and repeatedly progressive myelopathy with a mass. The pathological diagnosis of the mass was AVM; symptom-based surgical treatment with posterior decompression and the removal of epidural AVMs during the postoperative 12-month follow-up period were performed. The manual muscle testing grade score of the proximal and distal muscles in both lower limbs improved from 1 to 5, and the American Spinal Injury Association motor and sensation grade score improved from B to E. In the case of sudden or progressive spinal cord injury of unknown cause and acute spinal cord dysfunction, there might be a misdiagnosis. The key to a differential diagnosis is to take into account AVMs, and spontaneous hemorrhages and hematomas should also be suspected. Angiography and magnetic resonance imaging are very important for the diagnosis of AVM, and we hope to enhance clinicians' understanding of and vigilance for such diseases.

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