椎管内占位病例报告

A Case ofSudden Paralysis,Reporter： Tianwen XinSupervisor: Liang Chen, Yu Feng,Brief Medical History,Male patient, 32 years old.Chief complaint: Movement disorder and feelings disappeared in lower limbs for 8 hours.HPI: Sudden paralysis of lower limbs and feeling disappeared below the umbilicus level after ran a marathon match one day ago. Recovered after some massage in 4 hours. The same symptoms showed again the second day. The lumbar CT scan in Wuzhong Hospital reported no abnormal except tiny disk bulge in L5/S1.No other past disease history.,Physical Examination,Muscle strength of upper limbs: V Grade.Radioperiosteal reflex normal, Biceps tendon reflex normal, Hoffmanns sign(-).Muscle strength of lower limbs: 0 Grade. Sensorydisturbances of lower limbs.Knee jerk and Ankle jerk disappeared.Muscle tone of lower limbs increase.Feeling disappear below the umbilicus level.No percussion pain or tenderness in spine.,Blood glucose:7.37 mmol/L.(Normal 3.906.10)CRP:4.98 mg/L.(Normal 0.003.00)Neutrophil count:7.95*109/L.(Normal 1.806.30)Other lab examinations all normal.,Lab Examination,CT 2016-10-21Wuzhong Hospital,Imageological Examination,MRI 2016-10-21,Discussion,1.What is the diagnosis?2.How to explain the symptoms?3.Next treatment or examination?,X-Ray2016-10-22,Image,CT 2016-10-22,Image,T8,CT 2016-10-22,T9,T10,Image,MRI,2016-10-24,Image,MRI,2016-10-24,Discussion,1.What is the diagnosis?2.Differential diagnosis? Tumor(glioma, schwannoma, meningioma, teratoma, lipomyoma,or other metastatic tumor)? Hemangioma?3.Next treatment?,We did a posterior decompression and internal fixation of T8-T10 and probed the spinal canal then took the mass out.,Treatment,Images in surgery,Hematoma,Could this case be diagnosed as acute spontaneous spinal epidural hematoma（ASSEH）？Where is the