肝硬化合并自发性脊髓出血1例  

A case report of cirrhosis complicated with spontaneous spinal cord hemorrhage and literature review

作　　者：向靓 赵志鸿[1] 毛志群 Xiang Liang;Zhao Zhihong;Mao Zhiqun(Department of Neurology,the First Affiliated Hospital of Hunan Normal University/Hunan Provincial People′s Hospital,Changsha 410005,China;Department of Radiology,the First Affiliated Hospital of Hunan Normal University/Hunan Provincial People′s Hospital,Changsha 410005,China)

机构地区：[1]湖南师范大学附属第一医院/湖南省人民医院神经内科,长沙410005 [2]湖南师范大学附属第一医院/湖南省人民医院放射科,长沙410005

出　　处：《中华神经科杂志》2023年第7期796-799,共4页Chinese Journal of Neurology

基　　金：湖南省临床医疗技术创新引导项目(2020SK50920);湖南省自然科学基金(2021JJ70021)。

摘　　要：报道1例肝硬化合并自发性脊髓出血病例。患者为57岁男性,主要临床症状为急性起病,突发下肢肌力进行性下降,伴大小便失禁。胸段脊髓磁共振成像+磁共振血管造影+磁敏感加权成像表现:T_(1)WI序列脊髓内见细条状等及稍高信号,T_(2)WI序列相应部位见少许低信号灶,增强扫描无明显变化,磁敏感加权成像脊髓内见明显长条状低信号灶,范围较T_(2)WI序列明显增大。术前诊断为脊髓出血,药物治疗无明显好转,手术切开后诊断为自发性脊髓出血。A case of cirrhosis with spontaneous spinal cord hemorrhage is reported.The patient was a 57-year-old male,whose main clinical symptoms were acute onset,sudden progressive decline of lower limb muscle strength,and incontinence.Magnetic resonance imaging+magnetic resonance angiography+susceptibility-weighted imaging of thoracic spinal cord showed that thin strip like equal and slightly high signal could be seen in the spinal cord of T_(1)WI sequence,a few low signal foci could be seen in the corresponding part of T_(2)WI sequence,and there was no obvious change in enhanced scanning.Obvious long strip like low signal foci were shown in the spinal cord of susceptibility-weighted imaging,and the range was significantly larger than that of T_(2)WI sequence.Spinal cord hemorrhage was diagnosed before operation,and no obvious improvement was found after drug treatment.Spontaneous spinal cord hemorrhage was diagnosed after surgical incision.

关 键 词：脊髓 出血 肝硬化 脾大 血小板减少 

分 类 号：R575.2[医药卫生—消化系统] R744[医药卫生—内科学]