PDF(Pubmed)
Abstract：
BACKGROUND: Spinal cord infarction (SCI) is a rare disease representing nearly 1% of all strokes with a wide variety of symptoms at presentation. SCI diagnosis is very challenging owing to its low incidence and the variety of symptoms, and could be misdiagnosed with neuromyelitis optica spectrum disorders (NMOSD).
METHODS: We describe the case of an 18-year-old girl who presented to the emergency department with acute neck pain and flaccid paralysis of the left upper and lower extremities. Few hours later, she developed apnea and was endotracheally intubated. Brain MRI was normal but spinal cord MRI revealed non-enhancing longitudinal abnormal high T2 signal intensity extending from C1 to C5. The patient underwent steroid therapy with methylprednisolone (1 g daily for 7 consecutive days) combined with physiotherapy. She was extubated after 3 weeks and discharged after 30 days of hospitalization with a muscle force of 4/5 in her left extremities.
CONCLUSIONS: Idiopathic SCI in adolescence is a rare but often devastating disorder with unknown pathophysiology, however, some specific conditions in adolescent such as mechanical stresses on the immature spine can be considered as risk factors for SCI development. Early diagnosis and treatment can improve outcomes in SCI.
METHODS: We describe the case of an 18-year-old girl who presented to the emergency department with acute neck pain and flaccid paralysis of the left upper and lower extremities. Few hours later, she developed apnea and was endotracheally intubated. Brain MRI was normal but spinal cord MRI revealed non-enhancing longitudinal abnormal high T2 signal intensity extending from C1 to C5. The patient underwent steroid therapy with methylprednisolone (1 g daily for 7 consecutive days) combined with physiotherapy. She was extubated after 3 weeks and discharged after 30 days of hospitalization with a muscle force of 4/5 in her left extremities.
CONCLUSIONS: Idiopathic SCI in adolescence is a rare but often devastating disorder with unknown pathophysiology, however, some specific conditions in adolescent such as mechanical stresses on the immature spine can be considered as risk factors for SCI development. Early diagnosis and treatment can improve outcomes in SCI.
摘要：
背景：脊髓梗塞（SCI）是一种罕见疾病，占所有中风的近1％，表现出各种各样的症状。SCI的诊断因其发病率低、症状多样而具有很大的挑战性,并可能被误诊为视神经脊髓炎谱系障碍（NMOSD）。
方法：我们描述了一个18岁女孩的病例，该女孩因急性颈部疼痛和左上肢和下肢松弛性麻痹出现在急诊科。几小时后,她出现了呼吸暂停，并接受了气管内插管。脑MRI正常，但脊髓MRI显示非增强的纵向异常高T2信号强度从C1延伸到C5。患者接受甲基强的松龙（每天1克，连续7天）联合物理治疗的类固醇治疗。3周后拔管，住院30天后出院，左肢肌肉力量为4/5。
结论：青春期特发性脊髓损伤是一种罕见但通常具有破坏性的疾病，其病理生理学未知，然而,青少年的一些特殊情况,如未成熟脊柱的机械应力,可被认为是SCI发展的危险因素.早期诊断和治疗可以改善SCI的预后。
方法：我们描述了一个18岁女孩的病例，该女孩因急性颈部疼痛和左上肢和下肢松弛性麻痹出现在急诊科。几小时后,她出现了呼吸暂停，并接受了气管内插管。脑MRI正常，但脊髓MRI显示非增强的纵向异常高T2信号强度从C1延伸到C5。患者接受甲基强的松龙（每天1克，连续7天）联合物理治疗的类固醇治疗。3周后拔管，住院30天后出院，左肢肌肉力量为4/5。
结论：青春期特发性脊髓损伤是一种罕见但通常具有破坏性的疾病，其病理生理学未知，然而,青少年的一些特殊情况,如未成熟脊柱的机械应力,可被认为是SCI发展的危险因素.早期诊断和治疗可以改善SCI的预后。
