Ricerca avanzata

Home > Riviste > European Journal of Physical and Rehabilitation Medicine > Fascicoli precedenti > Europa Medicophysica 1999 Giugno;35(2) > Europa Medicophysica 1999 Giugno;35(2):103-7



Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063

Periodicità: Bimestrale

ISSN 1973-9087

Online ISSN 1973-9095


Europa Medicophysica 1999 Giugno;35(2):103-7


Post-trau­matic ­cranio-cer­vical junc­tion epi­dural ­hematoma con­com­i­tant ­with pon­tom­e­dul­lary infarc­tion and tet­ra­plegia. Diag­nostic eval­u­a­tion and reha­bil­i­ta­tive treat­ment

Santilli V. 1, Insola A. 2, Finucci S. 3, Paris E. 1, Capici S. 1, Di Girolamo G. 3

1 Unità Spi­nale Uni­po­lare;
2 Neu­ro­fi­sio­logia, CTO - ­Roma;
3 ­Scuola di Spe­cia­liz­zaz­ione in Med­i­cina ­Fisica , e Ria­bil­i­taz­ione “Tor Vergata”, Roma

BACKGROUND: To ­report and dis­cuss a ­rare ­case of ­post-trau­matic, epi­dural ­hematoma ­located ven­trally at the cer­vi­com­e­dul­lary junc­tion ­with con­com­i­tant brain­stem infarc­tion. ­Post-trau­matic epi­dural he­matoma is usu­ally ­located dor­sally in the epi­dural ­space.
­METHODS: A 36-bed ­Spinal ­Unit ­within a stan­dard mul­ti­dis­ci­pli­nary struc­ture. ­Patient: a 65-­year-old ­woman ­with ­post-trau­matic ­spine ­injury.
­RESULTS: The ­main clin­ical ­finding in our ­patient was bilat­eral cor­ti­cos­pinal and cor­tic­o­bulbar ­tract involve­ment. The FIM ­score at admis­sion was 48 and 62 at dis­charge. MR ­showed the dis­place­ment and flat­tening of ­both the ­medulla oblon­gata and the ­most cra­nial por­tion of cer­vical ­cord due to the epi­dural he­matoma asso­ciated ­with an ­ischemic ­lesion of the pon­tom­e­dul­lary junc­tion. Cen­tral ­motor con­duc­tion ­studies ­revealed ­that the abnor­mality of the cen­tral ­motor path­ways was loc­al­ised at brain­stem ­level ­with ­normal con­duc­tion ­from the cer­vi­com­e­dul­lary junc­tion to the ­spinal ­cord.
CONCLUSIONS: ­This ­study ­reports the ­first ­case of ­spinal epi­dural hae­matoma ­located ven­trally in the cer­vical ­spine at the cer­vi­com­e­dul­lary junc­tion ­level and con­com­i­tant infarc­tion at pon­tom­e­dul­lary junc­tion fol­lowing a whip­lash ­injury. The neu­ro­phys­io­log­ical find­ings ­revealed paren­chymal ­damage at the ­level of the ­lower ­pons ­with no indi­ca­tions for sur­gical inter­ven­tion. ­Initiated in the inten­sive ­care ­unit, the man­age­ment ­strategy was con­ser­va­tive and ­involved ­both med­ical and reha­bil­i­ta­tive treat­ment. In our ­patient, ­motor and res­pir­a­tory func­tions ­were ­those ­most ­involved.

lingua: Inglese


inizio pagina