伴椎间盘突出的纤维软骨栓塞性脊髓梗死2例  

Fibrocartilage embolic spinal cord infarction with intervertebral disc-herniation:Two case report

作　　者：杨闽佳 黄峰黎 陈平 吴永胜 林佳君 许悦 YANG Minjia;HUANG Fengli;CHEN Ping;WU Yongsheng;LIN Jiajun;XU Yue(Department of Neurology,The First Hospital of Putian City,Putian,351100,China;Department of Clinical Medicine,Fujian Medical University,Fuzhou 350122,China;Department of Imaging,The First Hospital of Putian City,Putian 351100,China)

机构地区：[1]福建省莆田市第一医院神经内科,莆田351100 [2]福建医科大学临床医学部 [3]福建省莆田市第一医院影像科

出　　处：《中国神经精神疾病杂志》2024年第10期599-602,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：福建省莆田市第一医院神经内科(莆田351100)。

摘　　要：报道2例脊髓梗死患者,对其临床特点和影像学资料、预后转归进行总结。2例患者均表现为急性起病的截瘫、尿潴留。脊髓MRI提示脊髓T2高信号、弥散受限。病例1存在脊柱炎性改变,T6水平椎体见椎间盘钙化及突出;病例2见颈椎间盘突出,脊柱病变均邻近脊髓梗死平面,但未能直接造成急或慢性脊髓压迫症。2例患者临床表现为急性卒中事件,明确脊髓梗死诊断后给予抗血小板聚集或抗凝及康复治疗,患者肢体功能逐渐恢复接近正常。脊柱椎间盘病变相关的纤维软骨栓塞(fibrocartilage embolism,FCE)性脊髓梗死少见,治疗方案未达成共识。本病例为脊髓梗死的诊治流程及预后提供了经验并拓宽了思路。The clinical features,imaging data and prognosis of 2 patients with spinal cord infarction were summarized.Both patients presented with acute onset paraplegia and urinary retention.Spinal MRI showed high T2 signal and limited diffusion in the spinal cord.Patient 1 had spinal inflammatory changes and disc calcification and herniation at the T6 level.Cervical disc herniation was found in case 2 and the spinal lesions were all adjacent to the spinal infarct plane,but could not directly cause acute or chronic spinal cord compression.The clinical manifestations of two patients were acute stroke events.After the diagnosis of spinal cord infarction was confirmed,anti-platelet aggregation or anticoagulation and rehabilitation therapy were given,and the limb function of the patients gradually recovered to close to normal.The incidence of fibrocartilage embolism(FCE)associated with spinal disc disease is rare,and there is no consensus on treatment.This case provides experience and broadens thinking for the diagnosis,treatment and prognosis of spinal cord infarction.

关 键 词：脊髓梗死 椎间盘突出 核磁共振弥散序列 纤维软骨栓塞 随访 

分 类 号：R744.1[医药卫生—神经病学与精神病学] R681.5[医药卫生—临床医学]