脊髓硬脊膜动静脉瘘1例报道并文献复习

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摘要本文报道1 例脊髓硬脊膜动静脉瘘的患者。脊髓硬脊膜动静脉瘘发病具有下肢无力、尿便困难、感觉障碍，早期临床症状常不典型，临床极易漏诊、误诊。本例患者既往有脑出血病史，经治疗后病情好转，仍遗留右侧肢体无力。8月前出现双下肢无力，当地医院考虑脑血管病再发，未行脊髓相关检查，导致疾病在早期出现误诊。到遵义医科大学第二附属医院后结合病情行脊髓MRI 检查发现脊髓病变、脊髓血管畸形。综合患者临床症状、体征及脊髓影像学表现，明确诊断：脊髓硬脊膜动静脉瘘，通过本案例报道及复习文献，加深对脊髓硬脊膜动静脉瘘的认识，提高医生对该疾病的诊治能力。

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关键词 ：下肢无力, 排尿困难, 脊髓MRI, 脊髓硬脊膜, 动静脉瘘

Abstract：In this article, 1 Spinal dural arteriovenous fistula was reported. The onset signs of SDAVF include lower limb weakness, urination and defecation difficulties, and sensory disturbance. With atypical early clinical symptoms in most cases, it is susceptible to clinical underdiagnosis or misdiagnosis. The reported case was found with past medical history of cerebral hemorrhage, whose condition improved after medical treatment, but still had right limb weakness.Before August, he was found with the weakness in both lower limbs, local hospital considered the recurrence of cerebrovascular disease, but didn′t check up spinal cord, which led to the early misdiagnosis. At the Second Affiliated Hospital of Zunyi Medical University, this case was identified with spinal cord lesions and spinal vascular malformation by spinal cord MRI examination in consideration of the condition. The general consideration of clinical l symptoms, signs and spinal cord imaging findings led to the definitive diagnosis of SDAVF. The report and literature review of the case is expected to provide an insight into SDAVF and improve the ability of doctors to treat the disease.

Key words： Weakness of lower limbs Dysuria Spinal MRI Spinal dura mater Arteriovenous fistula

收稿日期: 2021-02-20

引用本文:

姚本海；刘海军；曾尤超；左浩；潘永洁；詹剑. 脊髓硬脊膜动静脉瘘1例报道并文献复习[J]. 中国当代医药, 2021, 28(19): 227-230.
YAO Ben-hai1 LIU Hai-jun2 ZENG You-chao1 ZUO Hao1 PAN Yong-jie1 ZHAN Jian1▲. Spinal dural arteriovenous fistula: a case report and literature review. 中国当代医药, 2021, 28(19): 227-230.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I19/227

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