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患者,男,58岁。因急起双下肢疼痛、无力,伴二便失禁4小时入院。既往有高血压病史12年,无外伤史。查体:神志清楚,颅神经正常,双上肢肌力正常,双下肢肌力近端Ⅱ级,远端Ⅰ级,肌张力低,腱反射消失,双侧病理征(一),胸_(12)以下深、浅感觉均明显减退,颈软,克氏征(一)。腰穿测压力1.08kPa,奎氏试验示椎管完全梗阻,脑脊液呈淡黄色,蛋白9.90g/L,糖、氯化物正常。初诊椎管内占位性病变,病后7天行椎管探查术,见胸_(10)～腰_1硬膜外腔有凝血块,长约10cm,并与硬膜囊粘连,硬膜下未见异常。术后病情无好转。讨论自发性硬膜外血肿较少见。Robertson 认为
Patient, male, 58 years old. Due to acute upper extremity pain, weakness, with incontinence 4 hours admission. Previous history of hypertension 12 years, no history of trauma. Examination: Consciousness, normal cranial nerves, double upper extremity muscular strength, proximal lower extremity muscular strength Ⅱ, distal Ⅰ, low muscle tension, tendon reflex disappeared, bilateral pathological signs (A), chest _ (12 ) The following deep, shallow feeling were significantly reduced, neck soft, Kirschner sign (a). Lumbar wear measured pressure 1.08kPa, Quing’s test showed complete obstruction of the spinal canal, cerebrospinal fluid was pale yellow, protein 9.90g / L, sugar, chloride normal. Initial diagnosis of vertebral canal space-occupying lesions, disease 7 days after spinal exploration, see the chest _ (10) ~ waist _1 epidural clot, about 10cm, and the dural sac adhesion, the dura No abnormalities under. No improvement after surgery. Discussion of spontaneous epidural hematoma rare. Robertson think