胸椎间盘突出合并硬脊膜动静脉瘘1例

摘要

目的 探讨胸椎间盘突出合并硬脊膜动静脉瘘的临床特点.方法 报告1例以胸椎间盘突出为临床表现的硬脊膜动静脉瘘病例并进行相关文献复习.结果 患者,女,65岁,因“双下肢麻木无力3个月,加重伴大小便失禁1个周”入院,入院后行胸椎X线、CT检查,诊断为胸椎间盘突出症,入院后予以卧床休息、脱水、营养神经、改善微循环等药物治疗,效果差,行胸椎MRI考虑胸腰段硬脊膜动静脉瘘可能性大,后行DSA证实动静脉瘘存在,行动静脉瘘切除术,患者症状明显改善.结论 胸椎间盘突出合并硬脊膜动静脉瘘的临床表现复杂,需与单纯胸椎间盘突出鉴别.%Objective To explore the clinical features of thoracic disc herniation complicated with dural arteriovenous fistula.Methods A case of thoracic disc herniation complicated with dural arteriovenous fistula was reported;and related literatures were reviewed.Results The patient was a 65 years old female.She came to hospital because both lower limbs were weak and numb for three months and progressed and complicated with incontinence for one week.After being hospitalized,thoracic X-ray and CT examination were taken and she was diagnosed with thoracic disc herniation.The main treatment included rest on bed,dehydration,nerve nutrition,microcirculation,and other drugs.But the effect was poor.Thoracic MRI showed that she might complicated with dural arteriovenous fistula;and this was confirm by DSA.After surgery,the patient's symptoms were significantly improved.Conclusions The clinical manifestations of thoracic disc herniation complicated with dural arteriovenous fistula is complex;and thoracic disc herniation complicated with dural arteriovenous fistula has to be identified from thoracic disc heniation.