Hematomielia

Hematomielia Hematomielia is spunarii the spinal bleeding occurred. Occurs mostly in young people after a spinal cord injury after spinal elongation or after an exercise, but may be the result of vascular malformation or vasculitis intraparenchimatoase products polyarteritis nodosa or lupus erythematosus, bleeding disorders or spinal cord infections and malignancies. The seat is normally found bleeding from the neck swelling. Outbreak of hemorrhagic intramedullary gray matter lies between the front and rear horns determine the presence of blood cell necrosis. In the case of large lesions may bleed into subarachnoid space to expand, resulting in a subarachnoid hemorrhage. Tumors and blood dyscrasias are due to dural or epidural bleeding, rarely occur after spinal or lumbar puncture. In terms of pathology, bleeding around the outbreak is developing a process of reparative glial hyperplasia, resulting in a scar formation or the formation of bone marrow cavities.
Clinic Clinical onset of spinal hemorrhage usually occurs suddenly. It is clinically manifested by pain intensity in upper limbs, then install a paralysis of all limbs, because bleeding often occurs in the neck swelling. Neurological examination in May highlights, along with quadriplegia and abolition of tendon reflexes. They meet and thermal sensitivity and pain disorders. Since the bleed extends dehorning and earlier signs of upper limb muscle atrophy and respiratory disorders (by affecting the phrenic nerve nucleus at C4). It may also meet, and a Horner syndrome, which is manifested by miosis, ptosis sudoratiei decrease in the affected eye hemifaciesului. After the shock is overcome, in these days when getting out of the bone cortex inhibitory influence, it objectifies exaggeration of tendon reflexes. In case of bleeding dural or epidural space, blood accumulates results in compression of the spinal root or roots. Symptoms page is dominated by focal or radicular pain of acute nature, followed by variable signs of damage to the spinal or medullary cone.
Diagnosis hematomieliei MRI (magnetic resonance imaging) is the most suitable for diagnosis. If the vascular malformation is suspected as the cause of bleeding, selective spinal angiography is performed. Hematomieliei differential diagnosis is made with: - Myelitis - in this case meets a paraplegic syndrome in a feverish state fund. - Siringomielia or intraspinal tumors - these conditions usually have a slow evolution. - Bleeding meningeeana - The patient presents with signs of impaired meningeeana and parenchyma signs are absent.
Treatment Therapy is generally supportive. If bleeding is the result of a vascular malformation, then intervenes in emergency surgery to evacuate the clot and cause vascular lesions resolve. If subaranoidiene which compress spinal bleeding is surgical decompression occurs.