Spinal cord hemorrhage

Introduction Spinal hemorrhage refers to a lesion caused by hemorrhage in the parenchymal tissue of the spinal cord. The disease is relatively rare, the cause of the disease is traumatic or spontaneous, and more common in external injuries. When the back is seriously injured or falls, the buttocks are traumatized, the weight is lifted, and the cough is severe, the intraspinal hemorrhage can be directly or indirectly induced. Spontaneous intraspinal hemorrhage can be seen in hemophilia, thrombocytopenic purpura, leukemia, acute CO poisoning and other diseases. Intraspinal hemorrhage can involve any segment of the spinal cord, myelin and axon rupture of damaged nerve cells, and reactive glial cells and phagocytic cells appear.

Cause

(1) Causes of the disease

When the back is seriously injured or falls, the buttocks are traumatized, the weight is lifted, and the cough is severe, the intraspinal hemorrhage can be directly or indirectly induced. Spontaneous intraspinal hemorrhage can be seen in hemophilia, thrombocytopenic purpura, leukemia, acute CO poisoning and other diseases.

(two) pathogenesis

Generally, traumatic hemorrhage often spreads over several segments, involving one side of the spinal cord and then the other side. When the amount of bleeding is large, the spinal cord can be broken through and enter the subarachnoid space. A small amount of bleeding can also be seen, and the bleeding is mostly located near the gray matter area of the central tube. Intraspinal hemorrhage can involve any segment of the spinal cord, myelin and axon rupture of damaged nerve cells, and reactive glial cells and phagocytic cells appear. Edema around the bleeding area.

an examination

Related inspection

Spinal MRI examination of blood routine

Mostly sudden onset. After trauma, there are many root pains, sudden paraplegia or quadriplegia within a few minutes to several hours, and most of them are "spin shock" status. At this time, the muscle tension of the limb is lowered, the tendon reflex disappears, and no pathological reflex is induced. After a few weeks, you can gradually appear to be defamatory.

There may be deep sensory loss and autonomic dysfunction below the injured spinal cord segment. Almost all have defecation or incontinence. Spinal cord hemorrhage often occurs in the thoracic segment, and hemorrhage in the cervical spinal cord is often accompanied by fever or difficulty breathing.

According to the history and rapid onset of the clinical manifestations of spinal cord injury, it is generally not difficult to diagnose.

Differential diagnosis

It should be differentiated from acute transverse myelitis, Leigh disease, subacute necrotizing myelitis, spinal cord vascular malformation. Acute myelitis often has a history of infection and increased leukocytosis in the cerebrospinal fluid. Spinal vascular malformation can be confirmed by spinal iodine angiography or spinal angiography. Leigh disease is an autosomal recessive hereditary disease. The limbs are spasmodic at the early stage and flaccid in the late stage. The initial stage of sensory disturbance is separation and the latter is complete. CSF can detect the phenomenon of protein cell separation. Myelography can show vascular abnormalities on the surface of the spinal cord, and the lesions are mostly in the lumbosacral segment.

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