intraspinal hemorrhage
Introduction
Introduction to intraspinal hemorrhage Spinal hemorrhage refers to the lesion caused by hemorrhage in the spinal cord tissue. The disease is rare, and the cause of the disease is traumatic or spontaneous. It is more common in traumatic injuries. basic knowledge The proportion of the disease: the incidence rate of the middle-aged and elderly people over 50 years old is about 0.001%-0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: pneumonia, acne, urinary tract infection
Cause
Causes of intraspinal hemorrhage
(1) Causes of the disease
When the back is seriously injured or injured, hip injury, heavy weight lifting, severe cough, etc., can directly or indirectly induce intraspinal hemorrhage, spontaneous intraspinal hemorrhage can be seen in hemophilia, thrombocytopenic purpura, leukemia, acute CO poisoning Waiting for the disease.
(two) pathogenesis
Generally, traumatic hemorrhage often spreads over several segments, involving one side of the spinal cord first, and then involving the other side. When the amount of bleeding is large, the spinal cord can be broken through the spinal cord and into the subarachnoid space. A small amount of bleeding can also be seen. In the gray matter area of the central canal, intraspinal hemorrhage can involve any segment of the spinal cord, the myelin sheath and axon rupture of the damaged nerve cells, and reactive glial cells and phagocytic cells appear, and edema occurs around the bleeding area.
Prevention
Prevention of intraspinal hemorrhage
Pay attention to safe production, pay attention to sports safety and prevent trauma.
Complication
Intraspinal hemorrhage complications Complications pneumonia acne urinary tract infection
Traumatic symptoms and secondary pneumonia caused by paraplegia, acne, urinary tract infections, etc.
Symptom
Symptoms of intraspinal hemorrhage Common symptoms Quadriplegia paraplegia Breathing difficulty Spinal cord hemorrhoids Reflexes disappeared Back pain Spinal cord compression muscle tension decreased
Most of them are sudden onset. After trauma, there are many root pains. In a few minutes to several hours, they are suddenly paraplegic or quadriplegia, and most of them are in the state of "spinal shock". At this time, the muscle tension of the limbs is reduced, and the tendon reflex disappears. Pathological reflexes, after a few weeks, can gradually appear the performance of spasticity.
There may be deep sensory loss and autonomic dysfunction below the injured spinal cord segment. Almost all of them have defecation or incontinence. Spinal cord hemorrhage often occurs in the thoracic segment. The intraspinal hemorrhage in the cervical segment is often accompanied by fever or difficulty in breathing.
Examine
Examination of intraspinal hemorrhage
Cerebrospinal fluid examination
Generally normal, but also bloody.
2. Other selective inspection items
It includes coagulation functions such as platelets, prothrombin, blood electrolytes, blood sugar, and urea nitrogen.
In early MRI, T1 and T2 were low signals. After 72 hours, T1 showed high signal and T2 showed low signal.
Diagnosis
Diagnosis and diagnosis of intraspinal hemorrhage
According to the history and rapid onset of the clinical manifestations of spinal cord injury, it is generally not difficult to diagnose.
It should be differentiated from acute transverse myelitis, Leigh disease, subacute necrotizing myelitis, spinal vascular malformation, acute myelitis often has a history of infection, leukocytosis in cerebrospinal fluid, spinal cord vascular malformation or spinal iodine angiography or spinal angiography Checked and diagnosed, Leigh disease is an autosomal recessive hereditary disease. The limbs are sputum at the beginning and flaccid in the late stage. The initial stage of sensory dysfunction is separability, and the late stage is complete. CSF can detect protein cell separation and can be seen by myelography. There are abnormal blood vessels on the surface of the spinal cord, and the lesions are mostly in the lumbosacral segment
