| 摘要 |
Symptomatic herniated thoracic discs are uncommon entities that are difficult to be diagnosed. They are always associated with a myriad of symptoms, which often delay diagnosis. We present such a case of delayed diagnosis of traumatic thoracic disc herniation with neurologic deficit.
The patient was transferred to our ER due to traumatic ICH with multiple injuries. He was operated on twice, once for ICH, and the other time for a trochanteric fracture. "The post-operative condition was smooth, however, paraplegia with urine retention was found through the consciousness (coma Scale E4V2M6) which improved at the sixth week after admission. " the MRI of thoracic spine revealed a large disc herniation between T10 and T11, though the plain x-ray of the T-L spine did not demonstrate any spinal lesion except fracture of the right 11th rib. He received surgical decompression and physical therapy postoperatively, but paraplegia persisted.
The causes of delayed diagnosis were: 1) failure to take a complete survey. 2) an altered level of consciousness due to head injury. 3) multiple injuries with an undocumented missed injury. None of the missed injuries resulted in death, however missed injury caused serious disability. We would like to suggest that early diagnosis and adequate treatment are still needed to achieve the best outcome. |
