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Acute spontaneous spinal subdural hematoma presenting with Takotsubo cardiomyopathy: a rare case report and literature review.
EFORT Open Reviews ( IF 3.4 ) Pub Date : 2022-05-05 , DOI: 10.1530/eor-22-0003
Jie Xiang 1 , Weibo Zhao 1 , Xiao Luo 2 , Zhenghua Hong 1 , Hua Luo 1
Affiliation  

Spontaneous spinal subdural hematoma (SSDH) is a rare and dangerous intraspinal hematoma that usually occurs in the thoracic vertebra. The influence of early cardiovascular changes secondary to spinal cord injury is an important emergent issue. Herein, we report a case of a middle-aged woman with clinical manifestations of back pain and motion and sensory disturbances below the level of spinal cord compression. During the disease course, she also developed changes indicative of myocardial injury, such as tachycardia, markedly increased concentrations of brain natriuretic peptide and cardiac troponin I, and a decreased left ventricular ejection fraction, which were consistent with the diagnosis of Takotsubo cardiomyopathy (TTC). After the administration of supportive therapies, the symptoms of myocardial injury rapidly resolved. With the absorption of SSDH, the symptoms and clinical signs were alleviated. We also reviewed the literature on cases of concomitant SSDH and TTC. This rare case broadens the symptom spectrum of SSDH and highlights the need for clinicians to be aware of concomitant SSDH and TTC. Initial conservative treatment is a viable option for SSDH with concomitant TTC. However, urgent surgery may be a better option if the SSDH progressively enlarges and causes spinal cord compression.

中文翻译:

急性自发性脊髓硬膜下血肿伴 Takotsubo 心肌病:罕见病例报告及文献复习。

自发性脊髓硬膜下血肿(SSDH)是一种罕见且危险的脊髓内血肿,通常发生在胸椎。继发于脊髓损伤的早期心血管变化的影响是一个重要的紧急问题。在此,我们报告一例临床表现为背痛和运动以及脊髓受压水平以下感觉障碍的中年妇女的病例。在病程中,她还出现了提示心肌损伤的变化,如心动过速、脑利钠肽和心肌肌钙蛋白 I 浓度显着升高,以及左心室射血分数降低,这与 Takotsubo 心肌病 (TTC) 的诊断一致. 给予支持疗法后,心肌损伤症状迅速消退。随着SSDH的吸收,症状和临床体征得到缓解。我们还回顾了伴随 SSDH 和 TTC 病例的文献。这种罕见的病例拓宽了 SSDH 的症状范围,并强调了临床医生需要注意伴随的 SSDH 和 TTC。对于伴随 TTC 的 SSDH,初始保守治疗是一个可行的选择。然而,如果 SSDH 逐渐扩大并导致脊髓受压,紧急手术可能是更好的选择。
更新日期:2022-05-05
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