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儿童的脊髓动静脉畸形(AVM)很少,在幼儿本病尤为少见。本文报告一例出生2天的新生儿因脊髓AVM 致严重下肢瘫痪。患儿经妊娠38周,因头盆不称而剖腹产。生后24小时内未发现神经症状。突然出现心律不齐,脐以下尤其是下肢皮肤苍白。随之下肢肌力明显减退,双侧T_(10)平面以下感觉消失。怀疑脊髓梗塞,用肝素治疗。检查:体重2.56kg,身长46cm,前囟软,头围33cm,双下肢松弛性瘫痪,双侧T_(11)平面以下痛觉消失、上肢腱反射活跃,下肢消失,生后2天行脊髓造影。显示圆锥部明显扩大,终丝亦明显增粗。脊髓前动脉似有异常扩张和扭曲。CT 扫描证实脊髓增粗,但未显示髓内出血。术前鉴别诊断包括:脊髓AVM、圆锥髓内肿瘤、脊髓拴系并有脂肪组织粘附于终丝以及脊
Children with spinal cord arteriovenous malformations (AVM) is very rare in young children this disease is particularly rare. This article reports a case of severe lower extremity paralysis in a newborn born 2 days after spinal cord AVM. Children after 38 weeks of pregnancy, caesarean section due to cephalopelvic disproportion. Neurological symptoms were not found within 24 hours after birth. Suddenly arrhythmia, especially below the navel skin pale. As a result, the muscle strength of the lower extremities decreased significantly, and the sensation below the T_ (10) plane disappeared. Suspected spinal cord infarction, with heparin treatment. Examination: body weight 2.56kg, length 46cm, bregma, head circumference 33cm, both lower limb paralysis flaccid, bilateral T_ (11) plane pain disappeared, upper limb tendon reflex active, lower extremities disappeared, 2 days after birth, myelography. Cone significantly expanded, the final wire also significantly thicker. Spinal anomalies seem to be abnormally dilated and distorted. CT scans confirmed spinal thickening, but did not show intramedullary hemorrhage. Preoperative differential diagnosis include: spinal cord AVM, conical intramedullary tumors, tethered spinal cord and adipose tissue adhesion to the terminal filament and the ridge