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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Spinal epidural hematoma as a stroke mimic
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Spinal epidural hematoma as a stroke mimic

机译：脊柱硬膜外血肿作为中风模仿

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Purpose: Spinal epidural hematoma is a rare but important disease as it can be a stroke mimic. Our aim was to investigate the clinical characteristics of patients with an activated stroke code and spinal epidural hematoma. Methods: Patients with an activated stroke code were examined retrospectively. Patients with spinal epidural hematoma were evaluated with further neurological examinations and neuroimaging. Results: Of 2866 patients with an activated stroke code, spinal epidural hematoma was detected in 5 (0.2%, 63-79 years, 2 men). In all 5 cases, hematoma was located in the unilateral dorsal region of the spinal canal and spread to 5-9 vertebral segments at the C1-T3 level. None of the patients had a medical history of head or neck injury, coagulopathy, or use of anti-thrombotic agents. All of the patients had occipital, neck, and/or back pain, and their hemiparesis occurred simultaneously or within 1 h after the onset of pain. Hyperalgesia ipsilateral to the hematoma was observed in 1 patient, hypoalgesia contralateral to the hematoma was observed in 1, and quadriparesis and bilateral hypoalgesia were observed in 1. The hematomas spontaneously decreased in size in 4 patients, and cervical laminectomy was performed in the other patient. In the 1860 patients with an activated stroke code and spontaneous eye opening, the sensitivity of pain as a predictor of spinal epidural hematoma was 100%, with a specificity of 88.7%, and positive predictive value of 2.3%. Conclusion: Patients with spinal epidural hematoma could present with clinical characteristics mimicking ischemic stroke. Spinal epidural hematoma should be differentiated in patients treated under stroke code activation.
机译：目的：脊髓硬膜外血肿是一种罕见但重要的疾病，因为它可以模拟中风。我们的目的是研究激活卒中代码和脊髓硬膜外血肿患者的临床特征。方法：对脑卒中代码激活的患者进行回顾性检查。对脊髓硬膜外血肿患者进行进一步的神经学检查和神经影像学检查。结果：在2866例卒中代码激活的患者中，5例（0.2%，63-79岁，2名男性）出现脊髓硬膜外血肿。在所有5例患者中，血肿均位于椎管的单侧背侧区域，并在C1-T3水平扩散至5-9个椎体段。没有一名患者有头部或颈部受伤、凝血障碍或使用抗血栓药物的病史。所有患者均有枕骨、颈部和/或背部疼痛，且他们的偏瘫同时发生或在疼痛开始后1小时内发生。1例血肿同侧出现痛觉过敏，1例血肿对侧出现痛觉减退，1例出现四肢麻痹和双侧痛觉减退。4名患者的血肿自发缩小，另一名患者进行了颈椎椎板切除术。在1860名中风代码激活且自发睁眼的患者中，疼痛作为脊髓硬膜外血肿预测因子的敏感性为100%，特异性为88.7%，阳性预测值为2.3%。结论：脊髓硬膜外血肿患者可能具有类似缺血性卒中的临床特征。在卒中代码激活治疗的患者中，应区分脊髓硬膜外血肿。

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