Spontaneous spinal epidural hematoma is uncommon , The classical clinical presentation is acute onset of severe irradiating back pain , followed by the signs and symptolns of a rapidly evolving spinal cord compression . Early diagnosis fbllowed by immediate treatment of the cases mentioned here achieved good P 「ognoses . We describe three cases of spontaneous acute spinal epidural hematoma . All cases were diagnosed by magnetic resonance imaging (MRI)and treated by decompressive surgery as soon as possible, and all patients showed good postoperative recovery . We also review 123 cases of spontaneous acute spinal epidural hematoma previously reported in the literature . Key word : spinal epiduraI hematoma , spontaneous , MRI , early treatment Spina 且 Sllrgery 14 (2):117-124 , 2000
We report a case of cruciate paralysis with a Jefferson ' s fracture and atlanto − occipital dislocation . A58 − year −old rnan was referred to our hospital because of an accidcntal fall . At the neurological exa 皿 ination , a bilatelaI motor deficit was observed in the upper limbs , but the lower limbs did not appear to be affected . Lef巨ower cranial nerves (IX , X , XII) dysfullctlon were noted . Three − dimensional CT of the cervical spine de皿 onstrated an atlanto − occipita 】dislocation . MRI showed that the medullo − cervical junction was squeezed between tlc occipit 田 bQne and the axis . The patient was treated using a ha正 o vest and , about three months later , he was treated by occipitocervical fusion . About onc month after the operation , he was discharged 丘o 皿 our hospital without any neurological deficits . Cruciate paralysis is an uncommon
Summary:When dural arteriovenous fistula (DAVF) is associated with leptomeningeal venous drainage (LMVD), most cases have venous hypertension and concomitant venous congestion in the same areas due to reduced venous circulation. On the other hand, some cases in the DAVF with LMVD have no low-perfusion area. We studied this phenomenon. The subjects were 25 patients with DAVF. Of them, 16 cases had LMVD. Eleven had a low-perfusion area but 5 had no low-perfusion area. We analyzed this phenomenon in 5 cases. Two cases had anterior cranial fossa DAVF, 2 had tentorium DAVF, and 1 had transverse-sigmoid sinus DAVF. The characteristics of these DAVF are: 1) extra-sinusal type or pure leptomeningeal venous drainage, 2) low shunt flow, 3) existence of accessory route.
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