脊髓疾病思考题

脊髓疾病思考题

脊髓疾病思考题

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1. 脊髓半切综合征的临床表现有哪些?

答:病变节段以下同侧上运动神经元性瘫痪、深感觉障碍、精细触觉障碍及血管舒缩功能障碍,对侧痛温觉障碍。

motor neuron paralysis, deep sensory disturbance, fine tactile disturbance and vasomotor dysfunction on the ipsilateral side below the diseased segment, and pain and temperature disturbance on the contralateral side.

2. 脊髓休克的临床表现有哪些?

答:损伤平面以下弛缓性瘫,肌张力低,腱反射减弱或消失,无病理征。一般持续2~4周。后期则出现肌张力增高、腱反射亢进、病理征(+)、 反射性排尿。

peripheral paralysis usually lasts for 2-4 weeks. After that, reflex activity gradually recovers and turns into central paralysis.

3. 髓内病变、髓外硬膜内病变和硬膜外病变的鉴别要点是什么?

答:早起症状,髓内为双侧,其他为一侧;神经根痛,髓外为早期;感觉障碍,髓内为分离性、马鞍回避,髓外为传导束性,开始于一侧;痛温觉,髓内在上而下发展,髓外自下而上发展,半切综合征髓外多见;阶段性肌无力和萎缩髓内早期初心,广泛明显;锥体束症髓外早期出现;括约肌功能障碍髓内病变早期出现;棘突压痛、叩痛,髓外较常见;椎管梗阻髓外早期出现,且CSF较多;脊柱X线平片改变髓外有;髓外造影出现杯口状;MRI 髓外肿块及脊髓移位,髓内梭形膨大。

early rising symptoms, intramedullary is bilateral, others are unilateral; Nerve root pain, extramedullary is early; Sensory disturbance, dissociation and saddle avoidance in intramedullary, conduction bundle in extramedullary, starting from one side; The sensation of pain and warmth develops from top to bottom inside the medulla and from bottom to top outside the medulla. Hemitomy syndrome is more common outside the medulla; Stage muscle weakness and atrophy, early initial heart in medulla, extensive and obvious; Extramedullary pyramidal tract disease appeared early; Sphincter dysfunction and intramedullary lesions appeared early; Tenderness and percussion pain of spinous process are common outside the medulla; Spinal canal obstruction appeared early extramedullary, and CSF was more; X-ray plain film of spine showed extramedullary changes; Cup mouth appearance on extramedullary radiography; MRI showed extramedullary mass and spinal cord displacement, intramedullary spindle enlargement.